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Transjugular portosystem

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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/28246514/comparison-of-transjugular-intrahepatic-portosystemic-shunt-with-covered-stent-and-balloon-occluded-retrograde-transvenous-obliteration-in-managing-isolated-gastric-varices
#5
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
#6
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/28228886/transjugular-intrahepatic-portosystemic-shunt-for-chylous-ascites-in-a-patient-with-recurrent-cirrhosis-following-liver-transplantation
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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/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
#13
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/28118177/home-based-drainage-of-refractory-ascites-by-a-permanent-tunneled-peritoneal-catheter-can-safely-replace-large-volume-paracentesis
#14
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
#15
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/28070962/transjugular-intrahepatic-portosystemic-shunt-indications-complications-survival-and-its-use-as-a-bridging-therapy-to-liver-transplant-in-western-australia
#16
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
#17
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
#18
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...
February 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
#19
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
#20
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
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