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https://www.readbyqxmd.com/read/28293378/hepatorenal-syndrome-update-on-diagnosis-and-therapy
#1
EDITORIAL
Juan G Acevedo, Matthew E Cramp
Hepatorenal syndrome (HRS) is a manifestation of extreme circulatory dysfunction and entails high morbidity and mortality. A new definition has been recently recommended by the International Club of Ascites, according to which HRS diagnosis relies in serum creatinine changes instead that on a fixed high value. Moreover, new data on urinary biomarkers has been recently published. In this sense, the use of urinary neutrophil gelatinase-associated lipocalin seems useful to identify patients with acute tubular necrosis and should be employed in the diagnostic algorithm...
February 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28291716/the-relevance-of-readmissions-after-common-ir-procedures-readmission-rates-and-association-with-early-mortality
#2
Ammar Sarwar, Lujia Zhou, Nihara Chakrala, Olga R Brook, Jeffrey L Weinstein, Max P Rosen, Muneeb Ahmed
PURPOSE: To determine all-cause readmission rates for 12 IR procedures and association of time to readmission with risk-adjusted 90-day mortality. MATERIALS AND METHODS: Patients discharged after 12 inpatient IR procedures at a tertiary-care hospital between June 2008 and May 2013 (N = 4,163) were categorized as no readmission (n = 1,479; 40.5%) or readmission between 0 and 7 (n = 379; 10.4%), 8 and 30 (n = 650; 17.8%), 31 and 60 (n = 378; 10.3%), 61 and 90 (n = 169; 4...
March 10, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28286557/covered-versus-bare-stents-for-transjugular-intrahepatic-portosystemic-shunt-an-updated-meta-analysis-of-randomized-controlled-trials
#3
Xingshun Qi, Yulong Tian, Wei Zhang, Zhiping Yang, Xiaozhong Guo
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is a standard treatment option for the management of portal hypertension in liver cirrhosis. Since the introduction of covered stents, shunt patency has been greatly improved. However, it remains uncertain about whether covered stents could improve survival. A meta-analysis of randomized controlled trials has been performed to compare the outcomes of covered versus bare stents for TIPS. METHODS: PubMed, EMBASE, and Cochrane Library databases were searched to identify the relevant randomized controlled trials...
January 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28249809/opportunities-for-improvement-in-the-contemporary-management-of-acute-variceal-hemorrhage-a-systematic-review-of-observational-studies
#4
REVIEW
Elliot B Tapper, Lauren Beste, Michael Curry, Alan Bonder, Akbar Waljee, Sameer Saini
BACKGROUND AND AIMS: Gastroenterologists should strive to improve the outcomes associated with acute variceal hemorrhage (AVH) by optimizing care delivery and clinician preparedness through training. Unfortunately, data regarding contemporary outcomes and management of AVH are limited. METHODS: We performed a systematic review of cohort studies examining outcomes and management of AVH from January 1990 to September 2016. We pooled data on mortality and utilization of medical therapy, endoscopic interventions, balloon tamponade (BT), and salvage procedures (portal decompressive surgery or transjugular portosystemic shunt (TIPS))...
February 26, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28246589/difficult-endoscopic-diagnosis-of-a-pancreatic-plasmacytoma-case-report-and-review-of-literature
#5
Nicolas Williet, Radwan Kassir, Muriel Cuilleron, Olivier Dumas, Leslie Rinaldi, Karine Augeul-Meunier, Michèle Cottier, Xavier Roblin, Jean-Marc Phelip
A 71-year-old man, with history of plasmacytoma in relapse since one year, was hospitalized for a initial presentation of acute pancreatitis and hepatitis. Although there was a heterogeneous infiltration around the pancreas head, the diagnosis of an extramedullary localization of his plasmacytoma was not made until later. This delayed diagnosis was due to the lack of specific radiologic features and the lack of dilatation of biliary ducts at the admission. A diagnosis was made with a simple ultrasound guided paracentesis of the low abundance ascites after a transjugular hepatic biopsy, an endoscopic ultrasound-guided fine needle aspiration of the pancreatic mass, and a failed attempt of biliary drainage through endoscopic retrograde cholangiopancreatography...
February 10, 2017: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28246514/comparison-of-transjugular-intrahepatic-portosystemic-shunt-with-covered-stent-and-balloon-occluded-retrograde-transvenous-obliteration-in-managing-isolated-gastric-varices
#6
Seung Kwon Kim, Kristen A Lee, Steven Sauk, Kevin Korenblat
OBJECTIVE: Although a transjugular intrahepatic portosystemic shunt (TIPS) is commonly placed to manage isolated gastric varices, balloon-occluded retrograde transvenous obliteration (BRTO) has also been used. We compare the long-term outcomes from these procedures based on our institutional experience. MATERIALS AND METHODS: We conducted a retrospective review of patients with isolated gastric varices who underwent either TIPS with a covered stent or BRTO between January 2000 and July 2013...
March 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28245324/transjugular-intrahepatic-portosystemic-shunts
#7
Kamya Sankar, Christopher M Moore
No abstract text is available yet for this article.
February 28, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28243811/transjugular-tubercle-preaccessory-approach-for-ventrocaudally-located-pica-aneurysm
#8
Tetsuyoshi Horiuchi, Alhusain Nagm, Takatoshi Hasegawa, Kazuhiro Hongo
BACKGROUND: Posterior inferior cerebellar artery (PICA) aneurysms are often located in the ventral craniocervical junction. Such deep-seated aneurysms are usually treated with coil embolization. However, recurred and/or very small PICA aneurysms are hardly treated with an endovascular approach. METHOD: We present a modification of the transcondylar fossa approach with intradural and extradural removal of the jugular tubercle. An adequate preaccessory surgical corridor was created with this novel technique...
February 27, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28228886/transjugular-intrahepatic-portosystemic-shunt-for-chylous-ascites-in-a-patient-with-recurrent-cirrhosis-following-liver-transplantation
#9
Jason T Salsamendi, Francisco J Gortes, Prasoon P Mohan, Ji Fan, Govindarajan Narayanan
Chylous ascites (CA) is the extravasation of lipid-rich lymphatic fluid into the peritoneal space following trauma or obstruction of the lymphatic system. Refractory cases of cirrhosis-related CA may be amendable to transjugular intrahepatic portosystemic shunting (TIPS). We present a case of TIPS in the setting of refractory CA secondary to cirrhosis of a transplanted liver graft. Following TIPS, the patient reported immediate improvement in abdominal pain and no longer requires paracentesis. Our case suggests TIPS to be a safe and effective treatment option for CA in liver transplant patients with cirrhosis...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28226323/immune-complex-membranoproliferative-glomerulonephritis-associated-with-transjugular-intrahepatic-portosystemic-shunts-in-alcohol-cirrhosis-two-case-reports
#10
Julio Hernández-Jaras, Jordi Espí-Reig, Rafael Alis, Ana-Maria García-Martínez, Diego Rodríguez-Ortega, Lourdes Roca-Argente, Jose-Luis Moll-Guillen
OBJECTIVE: To report two cases with alcoholic cirrhosis, that were treated with transjugular intrahepatic portosystemic shunt (TIPS) placement. CLINICAL PRESENTATION AND INTERVENTION: The two patients had a history of alcoholic cirrhosis and TIPS surgery was performed on them. In both cases, 4 months after TIPS placement, proteinuria was observed along with histological alterations characteristic of immune complex-MPGN. CONCLUSION: The TIPS in one patient was successful without immediate complication while the other patient was referred for combined liver-kidney transplant...
February 22, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/28223261/use-of-transabdominal-ultrasound-guided-transjugular-portal-vein-puncture-on-radiation-dose-in-transjugular-intrahepatic-portosystemic-shunt-formation
#11
Aniket N Tavare, Andrew Wigham, Anastasia Hadjivassilou, Abdulrahman Alvi, Anthie Papadopoulou, Antony Goode, Nick Woodward, David Patch, Dominic Yu, Neil Davies
PURPOSE: Transjugular intrahepatic portosystemic shunt (TIPS) creation is used to treat portal hypertension complications. Often the most challenging and time-consuming step in the procedure is the portal vein (PV) puncture. TIPS procedures are associated with prolonged fluoroscopy time and high patient radiation exposures. We measured the impact of transabdominal ultrasound guidance for PV puncture on duration of fluoroscopy time and dose. METHODS: We retrospectively analyzed the radiation dose for all TIPS performed over a four-year period with transabdominal ultrasound guidance for PV puncture (n=212, with 210 performed successfully and data available for 206); fluoroscopy time, dose area product (DAP) and skin dose were recorded...
February 22, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28216969/validation-of-prognostic-indices-in-egyptian-budd-chiari-syndrome-patients-a-single-center-study
#12
Mohammad Sakr, Sara M Abdelhakam, Soheir A Elsayed, Enas H Allam, Amir M Farid, Waleed Abdelmoaty, Azza M Hassan, Mohamed Shaker, Mohamed El-Gharib, Ahmed Eldorry
AIM: To compare predictive ability of Budd-Chiari syndrome (BCS) prognostic indices (PIs) for one-year survival and Transjugular intrahepatic portosystemic shunt (TIPS) patency. METHODS: This retrospective study enrolled 194 Egyptian patients with primary BCS who presented to the Budd-Chiari Study Group of Ain Shams University Hospital. Calculation of the available PIs was performed using Child-Pugh and model for end-stage liver disease scores, BCS-specific PIs (Clichy, New Clichy and Rotterdam) for all patients, and BCS-TIPS PI only for patients who underwent TIPS...
January 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28203285/automated-low-flow-ascites-pump-for-the-treatment-of-cirrhotic-patients-with-refractory-ascites
#13
REVIEW
Guido Stirnimann, Vanessa Banz, Federico Storni, Andrea De Gottardi
Cirrhotic patients with refractory ascites (RA) can be treated with repeated large volume paracentesis (LVP), with the insertion of a transjugular intrahepatic portosystemic shunt (TIPS) or with liver transplantation. However, side effects and complications of these therapeutic options, as well as organ shortage, warrant the development of novel treatments. The automated low-flow ascites pump (alfapump(®)) is a subcutaneously-implanted novel battery-driven device that pumps ascitic fluid from the peritoneal cavity into the urinary bladder...
February 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28176618/experience-of-liver-transplant-in-patients-diagnosed-with-budd-chiari-syndrome
#14
Syed Muhammad Raza, Saima Zainab, Ali Reza Shamsaeefar, Saman Nikeghbalian, Seyed Ali Malek Hosseini
OBJECTIVES: Budd-Chiari syndrome can lead to fulminant hepatic failure and cirrhosis. The treatment depends on the severity of disease. Liver transplant is a successful treatment option for those with advanced-stage disease. MATERIALS AND METHODS: In this retrospective study, we analyzed all liver transplants conducted for Budd-Chiari syndrome at the organ transplant unit of Shiraz University of Medical Sciences, Iran, from 1993 to January 2016. Overall, 3201 liver transplant procedures were performed...
February 7, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28168806/transcaval-core-biopsy-in-malignant-superior-vena-cava-obstruction-potential-for-single-stage-diagnosis-and-treatment
#15
Julian Maingard, Mark Brooks
Superior vena cava syndrome (SVCS) is secondary to obstruction of venous flow from the superior vena cava to the right atrium. Endovascular stenting is particularly useful when severe or rapidly progressive disease requires urgent treatment. In suspected mediastinal malignancy, transcaval biopsy can be combined with endovenous stenting to provide diagnosis and treatment in a single procedure. Three patients were referred for investigation and treatment of SVCS over a 20 month period. Under fluoroscopic guidance Cook Medical transjugular biopsy sets (with 20-gauge QuickCore biopsy needles) were used and two or three core biopsy samples were obtained...
February 7, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28163865/evaluation-of-the-success-rate-of-ultrasound-guided-transjugular-liver-biopsy-tjlb-and-the-associated-complications
#16
Masoud Pezeshki Rad, Hamidreza Sima, Reza Khazaeeian, Mahyar Mohammadifard
INTRODUCTION: Transjugular liver biopsy (TJLB) is a diagnostic radiological intervention, applied to patients with contraindications to percutaneous or laparoscopic liver biopsy. The aim of this study was to determine the safety, effectiveness, complications, and pathological impact of TJLB. METHODS: This cross-sectional study was conducted on 24 consecutive patients, undergoing TJLB at Imam Reza Hospital, affiliated to Mashhad University of Medical Sciences, from April 2010 to March 2011...
December 2016: Electronic Physician
https://www.readbyqxmd.com/read/28144391/impact-of-transjugular-intrahepatic-porto-systemic-shunt-on-post-liver-transplantation-outcomes-study-based-on-the-united-network-for-organ-sharing-database
#17
Khalid Mumtaz, Sherif Metwally, Rohan M Modi, Nishi Patel, Dmitry Tumin, Anthony J Michaels, James Hanje, Ashraf El-Hinnawi, Don Hayes, Sylvester M Black
AIM: To determine the impact of transjugular intrahepatic porto-systemic shunt (TIPS) on post liver transplantation (LT) outcomes. METHODS: Utilizing the United Network for Organ Sharing (UNOS) database, we compared patients who underwent LT from 2002 to 2013 who had underwent TIPS to those without TIPS for the management of ascites while on the LT waitlist. The impact of TIPS on 30-d mortality, length of stay (LOS), and need for re-LT were studied. For evaluation of mean differences between baseline characteristics for patients with and without TIPS, we used unpaired t-tests for continuous measures and χ(2) tests for categorical measures...
January 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28135795/-surgical-removal-of-migrated-coil-after-embolization-of-jejunal-variceal-bleeding-a-case-report
#18
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/28130066/timing-affects-measurement-of-portal-pressure-gradient-after-placement-of-transjugular-intrahepatic-porto-systemic-shunts-in-patients-with-portal-hypertension
#19
Gilberto Silva-Junior, Fanny Turon, Anna Baiges, Eira Cerda, Ángeles García-Criado, Annabel Blasi, Ferran Torres, Virginia Hernandez-Gea, Jaume Bosch, Juan Carlos Garcia-Pagan
BACKGROUND & AIMS: A reduction in portal pressure gradient (PPG) to below 12 mmHg after placement of a transjugular intrahepatic porto-systemic shunt (TIPS) correlates with the absence of further bleeding or ascites at follow-up examinations of patients with cirrhosis. The PPG is usually measured immediately after placement of the TIPS, when different circumstances can affect PPG values - this could affect determination of risk for decompensation. We investigated variations in PPG measurements collected at different time points after TIPS, aiming to identify a time point after which PPG values were best maintained...
January 24, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28127943/fungal-endotipsitis-a-case-report-and-literature-review
#20
Thomas R McCarty, Jordan Sack, Bakhtiar Syed, Roger Kim, Basile Njei
Endotipsitis is a broad term used to describe sustained and clinically significant bacteremia or fungemia from a suspected vegetation or thrombus within the transjugular intrahepatic portosytemic shunt (TIPS) device. Endotipsitis is a rare infection in post-TIPS patients and given the diagnostic challenges, there is a need to establish formal diagnostic criteria. Bacterial causes of endotipsitis have been well documented in the literature, but few fungal-associated etiologies have been published to date. With this paucity of data, treatment strategies are lacking regarding the role of antifungal duration, the aggressiveness of medical therapy, and the role of liver transplantation...
January 27, 2017: Journal of Digestive Diseases
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