Abstract：

Objective Transjugular intrahepatic portal systemic shunt (TIPS) is a comprehensive interventional therapeutic technique specially used for the interventional therapy of portal hypertension. During which, the puncture from hepatic vein to portal vein is a key technical difficulty, while the selection of puncture needle front end bending angle is vital to the puncture. The purpose of this paper is to propose a calculation method of puncture needle front end bending angle in accordance with individualized anatomical structure.Methods Firstly preoperative contrast-enhanced CT was collected, and preplanning of drawing puncture path was conducted on base of the portal vein phase CT image, then considering the geometrical characteristic of puncture needle front end, Bezier curve parametric equation wasadopted to depict the shape and bending deformation of puncture needle front end. By traversing each point satisfying the equation set, the appropriate position of needle tip was confirmed. Then puncture needle front end bending angle was obtained through curvature computing, fulfilling the quantitative calculation of bending angle parameter in preplanning. Finally the efficiency of this calculation method was evaluated through subjective evaluation of intraoperative operating parameters combined with postoperative summary comparison. Results Thirteen cases clinical verifications from two research centers proved that under the guidance of preplanning with this quantized calculation method, the mean puncture times were 3, 2 and mean puncture time were161 min, 142 min, respectively. Conclusions Bezier curved parametric equation based puncture needle front-end bending angle calculation method used in the preplanning of transjugular intrahepatic portal systemic shunt for guiding puncture to portal vein proves good effect.