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https://www.readbyqxmd.com/read/28203285/automated-low-flow-ascites-pump-for-the-treatment-of-cirrhotic-patients-with-refractory-ascites
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/28121521/transjugular-intrahepatic-portosystemic-shunts-in-patients-with-cirrhosis-with-refractory-ascites-comparison-of-clinical-outcomes-by-using-8-and-10-mm-ptfe-covered-stents
#9
Roberto Miraglia, Luigi Maruzzelli, Fabio Tuzzolino, Ioannis Petridis, Mario D'Amico, Angelo Luca
Purpose To compare the efficacy and complications of transjugular intrahepatic portosystemic shunt (TIPS) creation performed by using a 10-mm or an 8-mm-diameter polytetrafluoroethylene (PTFE)-covered stent in a consecutive series of patients with cirrhosis with refractory ascites (RA). Materials and Methods The institutional review board approved this retrospective study and informed consent was waived. One hundred seventy-one patients with RA (mean age, 58.7 years ± 10.3; 95% confidence interval [CI]: 57...
January 25, 2017: Radiology
https://www.readbyqxmd.com/read/28120471/a-prospective-study-of-the-utility-of-plasma-biomarkers-to-diagnose-alcoholic-hepatitis
#10
Julien Bissonnette, José Altamirano, Cécile Devue, Olivier Roux, Audrey Payancé, Didier Lebrec, Pierre Bedossa, Dominique Valla, François Durand, Hafid Ait Oufella, Pau Sancho-Bru, Joan Caballeria, Pere Ginès, Chantal M Boulanger, Ramon Bataller, Pierre-Emmanuel Rautou
: The diagnosis of alcoholic hepatitis (AH) often requires a transjugular liver biopsy (TJLB), a procedure not always readily accessible. We analyzed plasma biomarkers to estimate the presence of histological features of AH among patients with clinical suspicion of AH. Using ELISA, we tested M65 and M30 (circulating fragments of cytokeratin-18) and their respective fraction carried by microvesicles (MVs), CCL20 and TREM1. Leukocyte, platelet and endothelial-derived MVs were quantified by flow cytometry...
January 24, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28118177/home-based-drainage-of-refractory-ascites-by-a-permanent-tunneled-peritoneal-catheter-can-safely-replace-large-volume-paracentesis
#11
Philipp Solbach, Christoph Höner Zu Siederdissen, Richard Taubert, Szilvia Ziegert, Kerstin Port, Andrea Schneider, Katja Hueper, Michael P Manns, Heiner Wedemeyer, Elmar Jaeckel
BACKGROUND AND AIM: Refractory ascites has a poor prognosis. Recurrent large-volume paracentesis is the current standard of care; however, it results in circulatory dysfunction and renal dysfunction, and hospitalization is commonly required. Transjugular intrahepatic portosystemic shunt placement is not an option in a substantial number of patients because of contraindications. The placement of a tunneled peritoneal drainage catheter has been shown to be effective in patients with malignant ascites...
January 21, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28110540/portal-vein-thrombosis-in-patients-with-cirrhosis-undergoing-elective-transjugular-intrahepatic-portosystemic-shunt
#12
Wan Yue-Meng, Yu-Hua Li, Hua-Mei Wu, Jing Yang, Li-Hong Yang, Ying Xu
Portal vein thrombosis (PVT) is a common complication in cirrhosis. The aim of this study was to determine risk factors for PVT, assess the efficacy of anticoagulant therapy, and evaluate the effects of PVT on patients with cirrhosis undergoing elective transjugular intrahepatic portosystemic shunt (TIPSS). A total of 101 patients with cirrhosis undergoing elective TIPSS were prospectively studied. After TIPSS, all patients received preventive therapy for PVT and were followed up at 3, 6, 12, and 24 months...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28079667/stage-of-fibrosis-and-portal-pressure-correlation-in-nonalcoholic-steatohepatitis
#13
Achuthan Sourianarayanane, Jyothsna Talluri, Abinav Humar, Arthur J McCullough
BACKGROUND: Hepatic venous pressure gradient (HVPG) measurement correlates with staging of liver fibrosis. Patients with nonalcoholic steatohepatitis (NASH) have a different pattern of fibrosis compared with hepatitis C virus (HCV) with possible alterations in pressures. AIM: The aim of this study was to compare portal pressures with the stage of fibrosis in NASH in comparison with other liver diseases. PATIENTS AND METHODS: Records of all patients who had undergone transjugular liver biopsy with pressure measurements between January 2001 and June 2013 were reviewed...
January 10, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28079252/outcomes-of-surgical-shunts-and-transjugular-intrahepatic-portasystemic-stent-shunts-for-complicated-portal-hypertension
#14
I Hosokawa, R Adam, M-A Allard, G Pittau, E Vibert, D Cherqui, A Sa Cunha, H Bismuth, M Miyazaki, D Castaing
BACKGROUND: Transjugular intrahepatic portasystemic stent shunt (TIPSS), instead of surgical shunt, has become the standard treatment for patients with complicated portal hypertension. This study compared outcomes in patients who underwent TIPSS or surgical shunting for complicated portal hypertension. METHODS: This was a retrospective study of all consecutive patients who received portasystemic shunts from 1994 to 2014 at a single institution. Patients who underwent surgical shunting were compared with those who had a TIPSS procedure following one-to-one propensity score matching...
January 12, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28070962/transjugular-intrahepatic-portosystemic-shunt-indications-complications-survival-and-its-use-as-a-bridging-therapy-to-liver-transplant-in-western-australia
#15
Puraskar Pateria, Gary P Jeffrey, George Garas, Jonathan Tibballs, John Ferguson, Luc Delriviere, Yi Huang, Leon A Adams, Gerry MacQuillan
INTRODUCTION: Insertion of transjugular intrahepatic portosystemic shunt (TIPS) is an established therapeutic option to treat the complications of portal hypertension. The purpose of this study is to review the experience of a single Australian institute with TIPS and evaluation of result to emphasize the indication, aetiology of portal hypertension, prognostic factors, complications and survival. Use of TIPS as a bridge to liver transplantation was also analysed. METHOD: A retrospective cohort study of patients treated with TIPS at The Western Australian Liver Transplant Unit, Sir Charles Gairdner Hospital, over a period of 12 years...
January 9, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28069787/bilateral-indwelling-pleural-catheter-for-hepatic-hydrothorax
#16
Rossella D'Amato, Luisa E Eiroa González, Ana Isabel Hernández Méndez
A 68-year-old man with alcoholic liver cirrhosis and portal hypertension was admitted due to ascites. Bilateral severe hepatic hydrothorax did not resolve despite sodium restriction, and diuretic treatment, requiring repeated thoracentesis for relief of dyspnoea. Curative options, as transjugular intrahepatic portosystemic shunt and liver transplantation were both contraindicated. An attempt of pleurodesis was ineffective. Bilateral insertion of tunnelled pleural catheter allowed symptom control and home discharge...
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28058594/an-algorithm-for-management-after-transjugular-intrahepatic-portosystemic-shunt-placement-according-to-clinical-manifestations
#17
REVIEW
Seung Kwon Kim, Bryan G Belikoff, Carlos J Guevara, Seong Jin Park
We propose an algorithm for management after transjugular intrahepatic portosystemic shunt (TIPS) placement according to clinical manifestations. For patients with an initial good clinical response, surveillance Doppler ultrasound is recommended to detect stenosis or occlusion. A TIPS revision can be performed using basic or advanced techniques to treat stenosis or occlusion. In patients with an initial poor clinical response, a TIPS venogram with pressure measurements should be performed to assess shunt patency...
January 5, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28057091/-resting-state-functional-magnetic-resonance-study-of-brain-function-changes-after-tips-operation-in-patients-with-liver-cirrhosis
#18
C Liu, H B Wang, Y Q Yu, M Q Wang, G B Zhang, L Y Xu, J M Wu
Objective: To investigate the brain function changes in cirrhosis patients after transjugular intrahepatic portosystemic shunt (TIPS), resting-state functional MRI (rs-fMRI) performed and fractional amplitude of low frequency fluctuation (fALFF) was analyzed. Methods: From January 2014 to February 2016, a total of 96 cirrhotic patients from invasive technology department and infection department in the First Affiliated Hospital of Anhui Medical University were selected , the blood ammonia data of 96 cirrhotic patients with TIPS operation in four groups were collected after 1, 3, 6 and 12 month, and all subjects performed rs-fMRI scans...
December 20, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28052623/prevention-and-treatment-of-variceal-haemorrhage-in-2017
#19
REVIEW
Felix Brunner, Annalisa Berzigotti, Jaime Bosch
Variceal haemorrhage is a major complication of portal hypertension that still causes high mortality in patients with cirrhosis. Improved knowledge of the pathophysiology of portal hypertension has recently led to a more comprehensive approach to prevent all the complications of this condition. Thus, optimal treatment of portal hypertension requires a strategy that takes into account the clinical stage of the disease and all the major variables that affect the risk of progression to the next stage and death...
January 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28051803/observational-cohort-study-of-hepatic-encephalopathy-after-transjugular-intrahepatic-portosystemic-shunt-tips
#20
Michaela Routhu, Vaclav Safka, Sunil Kumar Routhu, Tomas Fejfar, Vaclav Jirkovsky, Antonin Krajina, Eva Cermakova, Ladislav Hosak, Petr Hulek
: Introduction and Aim: Hepatic encephalopathy (HE) is a common complication of transjugular intrahepatic portosystemic shunting (TIPS). It is associated with a reduced quality of life and poor prognosis. The aim of this study was to compare two groups of patients who did and did not develop overt HE after TIPS. We looked for differences between these groups before TIPS. MATERIALS AND METHODS: A study of 895 patients was conducted based on a retrospective analysis of clinical data...
January 2017: Annals of Hepatology
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