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Transjugular portosystem

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https://www.readbyqxmd.com/read/27904533/an-early-decision-of-transjugular-intrahepatic-portosystemic-shunt-may-be-considered-for-non-malignant-and-non-cirrhotic-portal-vein-thrombosis-with-ascites-a-concise-review-of-the-theoretical-possibility-and-practical-difficulty
#1
https://www.readbyqxmd.com/read/27875032/management-of-renal-failure-in-end-stage-liver-disease-a-critical-appraisal
#2
REVIEW
Xingxing S Cheng, Jane C Tan, W Ray Kim
Renal failure is a late consequence of end-stage liver disease (ESLD). Even with liver transplantation, pretransplant renal impairment remains a strong predictor of posttransplant mortality. This review seeks to summarize and critically appraise common therapies used in this setting, including pharmacologic agents, procedures (transjugular intrahepatic portosystemic shunt, renal replacement therapy), and simultaneous liver-kidney transplantation. More experimental extracorporal modalities, eg, albumin dialysis or bioartificial livers, will not be discussed...
December 2016: Liver Transplantation
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
#3
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/27816756/sarcopenia-is-risk-factor-for-development-of-hepatic-encephalopathy-after-transjugular-intrahepatic-portosystemic-shunt-placement
#4
Silvia Nardelli, Barbara Lattanzi, Sabrina Torrisi, Francesca Greco, Alessio Farcomeni, Stefania Gioia, Manuela Merli, Oliviero Riggio
BACKGROUND & AIMS: Hepatic encephalopathy (HE) is an important complication in patients with cirrhosis who received transjugular intrahepatic portosystemic shunts (TIPS). We investigated whether a decrease in muscle mass was associated independently with the occurrence of HE after TIPS. METHODS: We performed a prospective study of 46 consecutive patients with cirrhosis (mean age, 58.6 ± 9.1 y; mean model for end-stage liver disease score, 11.3 ± 3.3; mean Child-Pugh score, 7...
November 2, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27805025/transjugular-intrahepatic-portosystemic-shunt-for-budd-chiari-syndrome-with-diffuse-occlusion-of-hepatic-veins
#5
Fuliang He, Hongwei Zhao, Shan Dai, Yingfeng Wu, Lei Wang, Hongdong Huang, Zhendong Yue, Zhenhua Fan, Xiaoqun Dong, Fuquan Liu
Either acute or sub-acute Budd-Chiari syndrome (BCS) with diffuse occlusion of hepatic veins has a high mortality rate and remains challenging for clinical treatment. We aimed to evaluate the feasibility and safety of transjugular intrahepatic portosystemic shunt (TIPS) as a treatment for BCS with diffuse occlusion of hepatic veins. From January 2007 to December 2010, 100 patients were randomly recruited onto this study and 91 patients were treated with TIPS. 14 patients were defined as acute BCS group and 86 patients as sub-acute group...
November 2, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27797679/long-term-outcome-and-analysis-of-dysfunction-of-transjugular-intrahepatic-portosystemic-shunt-placement-in-chronic-primary-budd-chiari-syndrome
#6
Georges Hayek, Maxime Ronot, Aurélie Plessier, Annie Sibert, Mohamed Abdel-Rehim, Magaly Zappa, Pierre-Emmanuel Rautou, Dominique Valla, Valérie Vilgrain
Purpose To evaluate the long-term safety, technical success, and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in a series of patients with Budd-Chiari syndrome (BCS), and to determine the predictors of shunt dysfunction. Materials and Methods From 2004 to 2013, all patients with primary BCS referred for TIPS placement were included in the study. The primary and secondary technical success rates and the number and types of early (ie, before day 7) complications were noted. Factors associated with dysfunction were analyzed with uni- and multivariate analyses...
October 31, 2016: Radiology
https://www.readbyqxmd.com/read/27786554/real-time-3d-ct-image-guidance-for-transjugular-intrahepatic-portosystemic-shunt-creation-using-preoperative-ct-a-prospective-feasibility-study-of-20-patients
#7
Xuefeng Luo, Xiaoze Wang, Yin Zhao, Huaiyuan Ma, Linchao Ye, Li Yang, Jiaywei Tsauo, Mingshan Jiang, Xiao Li
OBJECTIVE: The purpose of this study is to prospectively evaluate the feasibility and efficacy of real-time 3D CT image guidance during transjugular intrahepatic portosystemic shunt (TIPS) creation. SUBJECTS AND METHODS: Between October 2013 and December 2013, a total of 20 patients were prospectively enrolled in the present study. Previously acquired portal venous phase CT datasets and intraoperative CT datasets were registered on a dedicated workstation. We accomplished semiautomatic registration for the datasets of 11 of 20 patients (55%), and we performed manual registration for the datasets of the remaining nine patients...
October 27, 2016: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27784438/-research-advances-in-diagnosis-and-treatment-of-post-transjugular-intrahepatic-portosystemic-shunt-hepatic-encephalopathy
#8
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/27777214/-effect-of-covered-stent-length-in-portal-and-hepatic-veins-on-long-term-clinical-efficacy-of-transjugular-intrahepatic-portosystemic-shunt
#9
Peng Hu, Si-Liang Chen, Zhi-Peng Lin, Jian-Bo Zhao, Yong Chen, Xiao-Feng He, Qing-le Zeng, Yan-Hao Li
OBJECTIVE: To evaluate the effect of the length of covered stents in the portal and hepatic veins on long-term clinical efficacy of transjugular intrahepatic portosystemic shunt (TIPS). METHODS: We retrospectively reviewed 53 cases receiving TIPSs between January, 2008 and December, 2011. All the shunts were created with Fluency stents (8 mm in diameter). Bare metal grafts of the same diameter were implanted to extend the length in the portal and hepatic veins as deemed necessary according to angiographic images...
October 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27761198/percutaneous-transhepatic-embolization-of-bleeding-rectal-varices-using-a-new-embolic-and-sclerotic-mixture-augmented-by-amplatzer-vascular-plug-2
#10
Ahmed Kamel Abdel-Aal, Nabila Dawoud, Amr Soliman Moustafa, Maysoon F Hamed, Souheil Saddekni
We report a case of 59-year-old female with non-alcoholic-steato-hepatitis (NASH) induced cirrhosis, who presented with hematochezia. The patient had a history of bleeding esophageal varices treated with endoscopic variceal ligation (EVL). Colonoscopy showed large rectal varices which were the source of her lower gastrointestinal bleeding (LGIB). Since endoscopic treatment for LGIB are limited, and because the patient had portal vein thrombosis which contraindicated transjugular intrahepatic portosystemic shunt (TIPS), we performed percutaneous transhepatic embolization of her rectal varices using a new mixture of embolic and sclerotic agents, followed by Amplatzer plug 2 (AVP 2)...
September 2016: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/27740526/%C3%A2-percutaneous-shunt-reduction-for-the-management-of-tips-induced-acute-liver-decompensation-a-follow-up-study
#11
Bart De Keyzer, Frederik Nevens, Annouschka Laenen, Sam Heye, Wim Laleman, Chris Verslype, Schalk van der Merwe, Geert Maleux
:  Background and rationale for the study. The purpose of this study was to assess the technical and clinical outcomes of transjugular intrahepatic portosystemic shunt (TIPS) reduction for the management of TIPS-induced acute liver decompensation. Between August 2000 and November 2013, 347 patients underwent a TIPS procedure in the authors' institution; 21/347 (6%) developed post-TIPS acute liver decompensation which was managed using a percutaneous shunt reduction technique. Patient demographics, laboratory tests before and after initial TIPS and TIPS reduction, procedural data and clinical follow-up data were analysed...
November 2016: Annals of Hepatology
https://www.readbyqxmd.com/read/27706896/the-soluble-mannose-receptor-is-released-from-the-liver-in-cirrhotic-patients-but-is-not-associated-with-bacterial-translocation
#12
Tea L Laursen, Sidsel Rødgaard-Hansen, Holger J Møller, Christian Mortensen, Stine Karlsen, Dennis T Nielsen, Susanne Frevert, Jens O Clemmesen, Søren Møller, Jørgen S Jensen, Flemming Bendtsen, Henning Grønbaek
BACKGROUND & AIMS: Intestinal bacterial translocation is involved in activation of liver macrophages in cirrhotic patients. Macrophages play a key role in liver inflammation and are involved in the pathogenesis of cirrhosis and complications. Bacterial translocation may be determined by presence of bacterial DNA and macrophage activation, by the soluble mannose receptor. We hypothesize that the soluble mannose receptor is released from hepatic macrophages in cirrhosis and associated with bacterial DNA, portal pressure and complications...
October 5, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27706547/-percutaneous-paraumbilical-embolization-of-bleeding-rectal-varices-due-to-portal-hypertension
#13
T Stuber, B Schmitz, H J Brambs
Introduction: Portal hypertension may lead to severe esophageal or rectal variceal bleeding. Case report: We present a case of a 67-year-old patient presenting with recurrent rectal variceal bleeding who was non-responsive to endoscopic treatment. We are reporting on an interventional therapeutic approach found in interdisciplinary consensus. Discussion: Endoscopy, surgery or TIPS (transjugular intrahepatic portosystemic shunt) can be performed in patients with gastrointestinal bleeding due to portal hypertension in liver cirrhosis...
October 5, 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27706545/rescue-therapy-of-a-refractory-rectal-variceal-bleeding-in%C3%A2-a-cirrhotic-patient-by-linton-nachlas-tube-and-tips-implantation-in-combination-with-variceal-embolization
#14
M Buechter, J M Theysohn, A Kahraman, P Manka, G Gerken, A Canbay, A Dechêne
Background: Transjugular intrahepatic portosystemic shunt (TIPS) is considered the gold standard for treatment of gastrointestinal variceal bleeding refractory to endoscopic therapy in patients with portal hypertension. Clinically relevant hemorrhage from rectal varices is less frequent than from other sources, and the therapeutic role of TIPS is still ambiguous. Case report: A 57-year-old female patient was referred to us in December 2015 with severe signs of decompensated alcohol-induced liver cirrhosis. During hospitalization, she presented with recurrent hematochezia from rectal varices following electrosurgical snare removal of a rectal adenoma...
October 5, 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27695164/safety-and-efficacy-of-2-octyl-cyanoacrylate-in-the-management-of-patients-with-gastric-and-duodenal-varices-who-are-not-candidates-for-transjugular-intrahepatic-portosystemic-shunts
#15
Luis Lizardo-Sanchez, James Burdick, James F Trotter
Gastric variceal bleeding is associated with significant morbidity and mortality in patients with portal hypertension and cirrhosis. Options are limited for patients who are not candidates for transjugular intrahepatic portosystemic shunts (TIPS). Cyanoacrylate injections have been reported to be efficacious in previous case series. The aim of this retrospective study was to report our single-center experience with the safety and efficacy of 2-octyl-cyanoacrylate in patients who were not TIPS candidates. Electronic medical records were reviewed for 16 patients who underwent a total of 18 esophagogastroduodenoscopies for acute gastric or duodenal variceal bleeding and secondary prophylaxis of gastric varices; 14 patients had cirrhosis with an average Model for End-Stage Liver Disease score of 16, and 2 patients had noncirrhotic portal hypertension...
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27694618/utility-of-doppler-ultrasonography-for-predicting-improvement-of-platelet-count-after-transjugular-intrahepatic-portosystemic-shunt
#16
Kianoush Ansari-Gilani, Babak Seddigh Tonekaboni, Dean A Nakamoto, Jamak Modaresi Esfeh
OBJECTIVE: Portal pressure gradient (PPG) after transjugular intrahepatic portosystemic shunt (TIPS) <12 mmHg has been reported as the only factor predictive of increase in platelet count. As flow velocities measured on Doppler ultrasound are related to pressure gradient based on the Bernoulli equation, we used this parameter to predict increased platelet count after TIPS placement. METHODS: A total of 161 consecutive patients who underwent TIPS placement entered this retrospective study...
October 2, 2016: Gastroenterology Report
https://www.readbyqxmd.com/read/27689206/therapeutic-challenges-for-symptomatic-portal-cavernoma-cholangiopathy
#17
Adriana Cavași, Voicu Mercea, Ofelia Anton, Ion Cosmin Puia
Although transjugular intrahepatic portosystemic shunts are most frequently used for the management of portal hypertension, the surgical approach is preferred for symptomatic portal cavernoma cholangiopathy. We present the case of a 25-year old female patient with a portal cavernoma secondary to catheterization of the umbilical vein at birth. She had had two episodes of esophageal variceal bleeding, successfully treated by endoscopic banding. and an episode of acute cholangitis secondary to portal cavernoma cholangiopathy...
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/27686414/feasibility-of-electromagnetically-guided-transjugular-intrahepatic-portosystemic-shunt-procedure
#18
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...
August 9, 2016: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/27672292/portal-biliopathy
#19
REVIEW
Mohammad S Khuroo, Ajaz A Rather, Naira S Khuroo, Mehnaaz S Khuroo
Portal biliopathy refers to cholangiographic abnormalities which occur in patients with portal cavernoma. These changes occur as a result of pressure on bile ducts from bridging tortuous paracholedochal, epicholedochal and cholecystic veins. Bile duct ischemia may occur due prolonged venous pressure effect or result from insufficient blood supply. In addition, encasement of ducts may occur due fibrotic cavernoma. Majority of patients are asymptomatic. Portal biliopathy is a progressive disease and patients who have long standing disease and more severe bile duct abnormalities present with recurrent episodes of biliary pain, cholangitis and cholestasis...
September 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27670147/procedural-and-shunt-related-complications-and-mortality-of-the-transjugular-intrahepatic-portosystemic-shunt-tipss
#20
D Bettinger, M Schultheiss, T Boettler, M Muljono, R Thimme, M Rössle
BACKGROUND: The implantation of a transjugular intrahepatic portosystemic shunt (TIPSS) is a complex angiographic procedure performed in patients with end-stage liver disease. Numerous case reports and narrative reviews have been published so far; however, studies systematically investigating procedural and shunt-related complications are lacking. AIM: To systematically investigate complications and mortality occurring during the index hospital stay and the early (4-week) period after TIPSS implantation...
November 2016: Alimentary Pharmacology & Therapeutics
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