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Transjugular intrahepatic portal systemic shunt

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https://www.readbyqxmd.com/read/30145856/-ascites
#1
REVIEW
Soung Won Jeong
Ascites is the most common cause of decompensation in cirrhosis, and 5% to 10% of patients with compensated cirrhosis develop ascites each year. The main factor of ascites formation is renal sodium retention due to activation of the renin-angiotensin-aldosterone system and sympathetic nervous system by the reduced effective volume secondary to splanchnic arterial vasodilation. Diagnostic paracentesis is indicated in all patients with a new onset of grade 2 or 3 ascites and in those admitted to hospital for any complication of cirrhosis...
August 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29977326/method-for-calculating-the-bending-angle-of-puncture-needle-in-preoperative-planning-for-transjugular-intrahepatic-portal-systemic-shunt-tips
#2
Xiaoli Zhu, Zhao Ran, Wanci Li, Wansheng Wang, Kangshun Zhu, Wensou Huang, Xin Gao
Transjugular Intrahepatic Portal Systemic Shunt is a comprehensive interventional therapy for portal hypertension. During this intervention, puncturing from hepatic vein into portal vein is a difficult step. Selecting puncture needle with a proper bending angle is vital to accurate puncture. Thus, this prospective study provides a method to calculate the angle of the puncture needle using preinterventional contrast-enhanced CT imaging. According to the geometrical characteristics of puncture needle, Bezier curve equation was adopted to describe its bending part...
2018: Computational and Mathematical Methods in Medicine
https://www.readbyqxmd.com/read/29909391/ectopic-varices-a-potential-cause-of-gastrointestinal-bleeding-in-patients-with-portal-hypertension
#3
Indira Bhavsar, Anthony W Rooney, Brooke Corning, Neeral L Shah
A newly diagnosed 53-year-old woman with cirrhosis has repeated gastrointestinal bleeding with resulting symptomatic anaemia. She underwent routine diagnostic endoscopic evaluation without localisation of the aetiology of her bleed. Ultimately, she was found to have ectopic varices in the small bowel as a result of underlying high portal pressures. She underwent transjugular intrahepatic portosystemic shunt for portal system decompression with resolution in her bleeding.
June 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29844939/clinical-applications-of-spleen-ultrasound-elastography-a-review
#4
REVIEW
Rafał Mazur, Milena Celmer, Jurand Silicki, Daniel Hołownia, Patryk Pozowski, Krzysztof Międzybrodzki
In the last few years, notable technical progress has taken place in ultrasound elastography. Qualitative methods have been replaced by quantitative ones, such as: transient elastography, acoustic radiation force impulse and shear wave elastography. Owing to the fact that the spleen is superficially located, it is possible to obtain reliable measuring accuracy of its hardness using sonoelastography. Lately, many researchers have been investigating how spleen elasticity changes in patients infected with hepatitis B virus or hepatitis C virus and in patients suffering from liver fibrosis, portal hypertension, esophageal varices or myelofibrosis...
March 2018: Journal of Ultrasonography
https://www.readbyqxmd.com/read/29210304/current-management-of-refractory-ascites-in-patients-with-cirrhosis
#5
REVIEW
Ruihong Zhao, Juan Lu, Yu Shi, Hong Zhao, Kaijin Xu, Jifang Sheng
Liver cirrhosis is a health problem worldwide, and ascites is its principal symptom. Refractory ascites is intractable and occurs in 5%-10% of all patients with ascites due to cirrhosis. Refractory ascites leads to a poor quality of life and high mortality rate. Ascites develops as a result of portal hypertension, which leads to water-sodium retention and renal failure. Various therapeutic measures can be used for refractory ascites, including large-volume paracentesis, transjugular intrahepatic portosystemic shunt, vasoconstrictive drugs, and an automated low-flow ascites pump system...
March 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29113006/transjugular-portal-vein-recanalization-with-creation-of-intrahepatic-portosystemic-shunt-pvr-tips-in-patients-with-chronic-non-cirrhotic-non-malignant-portal-vein-thrombosis
#6
Christoph Klinger, Bettina Riecken, Arthur Schmidt, Andrea De Gottardi, Benjamin Meier, Jaime Bosch, Karel Caca
PURPOSE: To determine safety and efficacy of transjugular portal vein recanalization with creation of intrahepatic portosystemic shunt (PVR-TIPS) in patients with chronic non-cirrhotic, non-malignant portal vein thrombosis (PVT). METHODS: This retrospective study includes 17 consecutive patients with chronic non-cirrhotic PVT (cavernous transformation n = 15). PVR-TIPS was indicated because of variceal bleeding (n = 13), refractory ascites (n = 2), portal biliopathy with recurrent cholangitis (n = 1), or abdominal pain (n = 1)...
March 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29105936/circulating-cxcl10-in-cirrhotic-portal-hypertension-might-reflect-systemic-inflammation-and-predict-aclf-and-mortality
#7
Jennifer M Lehmann, Karina Claus, Christian Jansen, Alessandra Pohlmann, Robert Schierwagen, Carsten Meyer, Daniel Thomas, Steffen Manekeller, Joan Claria, Christian P Strassburg, Christian Trautwein, Hermann E Wasmuth, Marie-Luise Berres, Jonel Trebicka
BACKGROUND & AIMS: CXCR% ligands play an important role in hepatic injury, inflammation and fibrosis. While CXCL9 and CXCL11 are associated with survival in patients receiving transjugular intrahepatic portosystemic shunt (TIPS), the role of CXCL10 in severe portal hypertension remains unknown. METHODS: A total of 89 cirrhotic patients were analysed. CXCL10 protein levels were measured in portal and hepatic blood at TIPS insertion and 2 weeks later in 24 patients...
May 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29074483/transjugular-intrahepatic-portosystemic-shunt-impact-on-systemic-hemodynamics-and-renal-and-cardiac-function-in-patients-with-cirrhosis
#8
Troels M Busk, Flemming Bendtsen, Jørgen H Poulsen, Jens O Clemmesen, Fin S Larsen, Jens P Goetze, Jens S Iversen, Magnus T Jensen, Rasmus Møgelvang, Erling B Pedersen, Jesper N Bech, Søren Møller
Transjugular intrahepatic portosystemic shunt (TIPS) alleviates portal hypertension and possibly increases central blood volume (CBV). Moreover, renal function often improves; however, its effects on cardiac function are unclear. The aims of our study were to examine the effects of TIPS on hemodynamics and renal and cardiac function in patients with cirrhosis. In 25 cirrhotic patients, we analyzed systemic, cardiac, and splanchnic hemodynamics by catheterization of the liver veins and right heart chambers before and 1 wk after TIPS...
February 1, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/28976657/variceal-haemorrhage-an-update-on-treatment
#9
Joseph Jy Sung
Recent advances in the management of variceal haemorrhage include injection of cyanoacrylate and the use of banding ligation. New pharmacological agents, such as somatostatin and octreotide, have also proved to be effective in controlling variceal haemorrhage. The transjugular intrahepatic porto-systemic shunt (TIPS) represents an effective rescue when other treatment modalities fail. A multi-disciplinary approach should be emphasized in the management of this high-risk complication of portal hypertension.
November 1998: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28893712/single-session-percutaneous-endovascular-mesocaval-shunt-creation-and-balloon-occluded-retrograde-transvenous-obliteration-for-the-treatment-of-gastric-varices
#10
Ravi Nara Srinivasa, Bill S Majdalany, Jeffrey Forris Beecham Chick, J Matthew Meadows, Jordan Bruce Fenlon, Charles Brewerton, Wael E Saad
In the setting of portal hypertension, the body responds by creating portosystemic venous shunts, which may lead to the development of varices. Endoscopic treatment of these varices is often warranted to prevent catastrophic bleeding. During the course of variceal treatment, 1 or more portosystemic shunts may be sacrificed, which may acutely exacerbate portal hypertension and reduce systemic venous return. This report describes percutaneous creation of a mesocaval shunt and balloon-occluded retrograde transvenous obliteration (BRTO) in a patient with cavernous transformation of the portal vein...
January 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28836115/management-of-ascites-and-hepatorenal-syndrome
#11
REVIEW
Salvatore Piano, Marta Tonon, Paolo Angeli
Ascites represents the most common decompensating event in patients with liver cirrhosis. The appearance of ascites is strongly related to portal hypertension, which leads to splanchnic arterial vasodilation, reduction of the effective circulating volume, activation of endogenous vasoconstrictor systems, and avid sodium and water retention in the kidneys. Bacterial translocation further worsens hemodynamic alterations of patients with cirrhosis and ascites. The first-line treatment of uncomplicated ascites is a moderate sodium-restricted diet combined with diuretic treatment...
February 2018: Hepatology International
https://www.readbyqxmd.com/read/28729141/effects-of-transjugular-intrahepatic-portosystemic-shunt-tips-on-blood-volume-distribution-in-patients-with-cirrhosis
#12
Troels M Busk, Flemming Bendtsen, Jens H Henriksen, Stefan Fuglsang, Jens O Clemmesen, Fin S Larsen, Søren Møller
BACKGROUND: Cirrhosis is accompanied by portal hypertension with splanchnic and systemic arterial vasodilation, and central hypovolaemia. A transjugular intrahepatic portosystemic shunt (TIPS) alleviates portal hypertension, but also causes major haemodynamic changes. AIMS: To investigate effects of TIPS on regional blood volume distribution, and systemic haemodynamics. METHODS: Thirteen cirrhotic patients had their regional blood volume distribution determined with gamma-camera technique before and after TIPS...
December 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28487619/one-step-minilaparotomy-assisted-transmesenteric-portal-vein-recanalization-combined-with-transjugular-intrahepatic-portosystemic-shunt-placement-a-novel-surgical-proposal-in-pediatrics
#13
Gloria Pelizzo, Pietro Quaretti, Lorenzo Paolo Moramarco, Riccardo Corti, Marcello Maestri, Giulio Iacob, Valeria Calcaterra
Transjugular intrahepatic portosystemic shunt (TIPS) placement is a standard procedure for the treatment of portal hypertension complications. When this conventional approach is not feasible, alternative procedures for systemic diversion of portal blood have been proposed. A one-step interventional approach, combining minilaparotomy-assisted transmesenteric (MAT) antegrade portal recanalization and TIPS, is described in an adolescent with recurrent esophageal varice bleeding and portal cavernoma (PC). A 16-year-old girl was admitted to our Unit because of repeated bleeding episodes over a short period of time due to esophageal varices in the context of a PC...
April 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28348478/portal-hypertension-imaging-of-portosystemic-collateral-pathways-and-associated-image-guided-therapy
#14
REVIEW
Murad Feroz Bandali, Anirudh Mirakhur, Edward Wolfgang Lee, Mollie Clarke Ferris, David James Sadler, Robin Ritchie Gray, Jason Kam Wong
Portal hypertension is a common clinical syndrome, defined by a pathologic increase in the portal venous pressure. Increased resistance to portal blood flow, the primary factor in the pathophysiology of portal hypertension, is in part due to morphological changes occurring in chronic liver diseases. This results in rerouting of blood flow away from the liver through collateral pathways to low-pressure systemic veins. Through a variety of computed tomographic, sonographic, magnetic resonance imaging and angiographic examples, this article discusses the appearances and prevalence of both common and less common portosystemic collateral channels in the thorax and abdomen...
March 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28135795/-surgical-removal-of-migrated-coil-after-embolization-of-jejunal-variceal-bleeding-a-case-report
#15
Junhwan Kim, Danbi Lee, Kyunghwan Oh, Mingee Lee, Seol So, Dong Hoon Yang, Chan Wook Kim, Dong Il Gwon, Young Hwa Chung
Jejunal variceal bleeding is less common compared with esophagogastric varices in patients with portal hypertension. However, jejunal variceal bleeding can be fatal without treatment. Treatments include surgery, transjugular intrahepatic porto-systemic shunt (TIPS), endoscopic sclerotherapy, percutaneous coil embolization, and balloon-occluded retrograde transvenous obliteration (BRTO). Percutaneous coil embolization can be considered as an alternative treatment option for those where endoscopic sclerotherapy, surgery, TIPS or BRTO are not possible...
January 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28051160/lipopolysaccharide-induced-neutrophil-dysfunction-following-transjugular-intrahepatic-portosystemic-stent-shunt-tipss-insertion-is-associated-with-organ-failure-and-mortality
#16
Jane Macnaughtan, Rajeshwar P Mookerjee, Schalk van der Merwe, Rajiv Jalan
Systemic lipopolysaccharide (LPS) is implicated in increasing mortality in patients with alcoholic hepatitis but the underlying mechanisms are not well characterised. The objective of this study was to characterise neutrophil function, LPS and cytokine concentrations within the splanchnic circulation of alcoholic cirrhotic patients undergoing TIPSS insertion for variceal haemorrhage and correlate this with outcome. 26 patients with alcoholic cirrhosis and variceal haemorrhage were studied prior to and 1-hour after TIPSS insertion...
January 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28018098/therapeutic-approaches-for-portal-biliopathy-a-systematic-review
#17
REVIEW
Irene Franceschet, Alberto Zanetto, Alberto Ferrarese, Patrizia Burra, Marco Senzolo
Portal biliopathy (PB) is defined as the presence of biliary abnormalities in patients with non-cirrhotic/non-neoplastic extrahepatic portal vein obstruction (EHPVO) and portal cavernoma (PC). The pathogenesis of PB is due to ab extrinseco compression of bile ducts by PC and/or to ischemic damage secondary to an altered biliary vascularization in EHPVO and PC. Although asymptomatic biliary abnormalities can be frequently seen by magnetic resonance cholangiopancreatography in patients with PC (77%-100%), only a part of these (5%-38%) are symptomatic...
December 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27853493/implantability-complications-and-follow-up-after-transjugular-intrahepatic-portosystemic-stent-shunt-creation-with-the-6f-self-expanding-sinus-superflex-visual-stent
#18
Daniel Spira, Jakub Wiskirchen, Ulrich Lauer, Dominik Ketelsen, Konstantin Nikolaou, Benjamin Wiesinger
BACKGROUND: The transjugular intrahepatic portosystemic stent-shunt (TIPSS) builds a shortcut between the portal vein and a liver vein, and represents a sophisticated alternative to open surgery in the management of portal hypertension or its complications. OBJECTIVES: To describe clinical experiences with a low-profile nitinol stent system in TIPSS creation, and to assess primary and long-term success. PATIENTS AND METHODS: Twenty-six patients (5 females, 21 males; mean age 54...
July 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
https://www.readbyqxmd.com/read/27784438/-research-advances-in-diagnosis-and-treatment-of-post-transjugular-intrahepatic-portosystemic-shunt-hepatic-encephalopathy
#19
REVIEW
J F Yang, B Q Zhang
Transjugular intrahepatic portosystemic shunt (TIPS) has become an important minimally invasive interventional technique for the treatment of complications of cirrhotic portal hypertension, and currently, it is often used in cirrhotic patients with esophagogastric variceal bleeding (EVB), intractable ascites, hepatic hydrothorax, and Budd-Chiari syndrome. On one hand, TIPS can effectively reduce portal vein pressure and the risk of EVB and intractable ascites; on the other hand, it may reduce the blood flow in liver perfusion, aggravate liver impairment, and cause porto-systemic encephalopathy...
July 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/27686414/feasibility-of-electromagnetically-guided-transjugular-intrahepatic-portosystemic-shunt-procedure
#20
Peter Isfort, Tobias Penzkofer, Christoph Wilkmann, Hong-Sik Na, Christian Kotzlowski, Nobutake Ito, Joachim Georg Pfeffer, Stefan Bisplinghoff, Sabine Osterhues, Andreas Besting, Jorge Gooding, Thomas Schmitz-Rode, Christiane Kuhl, Andreas Horst Mahnken, Philipp Bruners
OBJECTIVES: To develop an electromagnetic navigation technology for transjugular intrahepatic portosystemic shunt (TIPS) creation and translate it from phantom to an in-vivo large animal setting. MATERIAL AND METHODS: A custom-designed device for TIPS creation consisting of a stylet within a 5 French catheter as well as a software prototype were developed that allow real-time tip tracking of both stylet and catheter using an electromagnetic tracking system. Feasibility of navigated TIPSS creation was tested in a phantom by two interventional radiologists (A/B) followed by in-vivo testing evaluation in eight domestic pigs...
February 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
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