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Transjugular portosystem

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https://www.readbyqxmd.com/read/29340275/timing-of-transjugular-intrahepatic-portosystemic-shunt-for-budd-chiari-syndrome-an-italian-hepatologist-s-perspective
#1
Andrea Mancuso
Budd-Chiari syndrome (BCS) management flow-chart is derived from experts' opinion and is not evidence-based. Guidelines suggest BCS management should follow a stepwise strategy: medical therapy as first-line treatment, revascularization or transjugular intrahepatic portosystemic shunt (TIPS) if no response to medical therapy, and liver transplant as rescue therapy. Recent evidence suggests that only medical therapy results in a bad long-term outcome. The biggest criticism of guidelines is the indication that BCS should receive further treatment only when hemodynamic consequences of portal hypertension become clinically evident...
December 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/29338471/transjugular-intrahepatic-portosystemic-stent-shunt-placement-and-embolization-for-hemorrhage-associated-with-rupture-of-anorectal-varices
#2
Xiuyan Wu, Wei Xuan, Lei Song
Portal hypertension can lead to ectopic varices, which occur most frequently in the rectum. Rectal variceal bleeding in patients with portal hypertension is rare but can be life-threatening if not diagnosed and treated in a timely manner. However, no specific treatment guidelines have been established for rectal variceal bleeding. We herein report a case involving a woman with portal hypertension due to autoimmune liver disease who was successfully treated with a transjugular intrahepatic portosystemic stent shunt and variceal embolization...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29324586/ten-year-experience-of-transjugular-intrahepatic-portosystemic-shunt-for-noncirrhotic-portal-hypertension
#3
David Regnault, Louis d'Alteroche, Charlotte Nicolas, Fanny Dujardin, Jean Ayoub, Jean Marc Perarnau
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is considered to be well suited for the treatment of noncirrhotic portal hypertension (NCPHT) because of a usually severe portal hypertension (PHT) and a mild liver failure, but very less data are available. PATIENTS AND METHODS: Records of patients referred for TIPS between 2004 and 2015 for NCPHT were reviewed. No patient should have clinical or biological or histological features of cirrhosis. RESULTS: Twenty-five patients with a wide variety of histological lesions (sinusoidal dilatations, granulomatosis, regenerative nodular hyperplasia, obliterative portal venopathy, or subnormal liver) and a wide variety of associated diseases (thrombophilia, sarcoidosis, common variable immunodeficiency, scleroderma, Castleman's disease, early primitive biliary cirrhosis, congenital liver fibrosis, chemotherapy, purinethol intake, and congenital varices) were included...
January 10, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29316565/transjugular-intrahepatic-portosystemic-shunt-in-patients-with-portal-hypertension-patency-depends-on-coverage-and-interventionalist-s-experience
#4
Matthias Buechter, Paul Manka, Guido Gerken, Ali Canbay, Sandra Blomeyer, Axel Wetter, Jens Altenbernd, Alisan Kahraman, Jens M Theysohn
BACKGROUND AND AIMS: Transjugular intrahepatic portosystemic shunt (TIPS) is the treatment of choice in decompensated portal hypertension. TIPS revision due to thrombosis or stenosis increases morbidity and mortality. Our aim was to investigate patient- and procedure-associated risk factors for TIPS-revision. PATIENTS AND METHODS: We retrospectively evaluated 189 patients who underwent the TIPS procedure. Only patients who required TIPS revision within 1 year (Group I, 34 patients) and patients who did not require re-intervention within the first year (Group II [control group], 54 patients) were included...
January 9, 2018: Digestive Diseases
https://www.readbyqxmd.com/read/29315304/transjugular-intrahepatic-portosystemic-shunts-tips-for-the-prevention-of-variceal-re-bleeding-a-two-decades-experience
#5
Theresa Bucsics, Maria Schoder, Magdalena Diermayr, Maria Feldner-Busztin, Nicolas Goeschl, David Bauer, Philipp Schwabl, Mattias Mandorfer, Bernhard Angermayr, Manfred Cejna, Arnulf Ferlitsch, Wolfgang Sieghart, Michael Trauner, Markus Peck-Radosavljevic, Josef Karner, Franz Karnel, Thomas Reiberger
BACKGROUND AND AIMS: Transjugular intrahepatic portosystemic shunts (TIPS) are used in patients with cirrhosis for the prevention of variceal rebleeding. METHODS: We retrospectively evaluated re-bleeding rate, patency, mortality, and transplant-free survival (TFS) in cirrhotic patients receiving TIPS implantation for variceal bleeding between 1994-2014. RESULTS: 286 patients received TIPS (n = 119 bare metal stents, n = 167 polytetrafluorethylene (PTFE)-covered stents) for prevention of variceal re-bleeding...
2018: PloS One
https://www.readbyqxmd.com/read/29311408/hepatic-hydrothorax
#6
Yong Lv, Guohong Han, Daiming Fan
Hepatic hydrothorax (HH) is a pleural effusion that develops in a patient with cirrhosis and portal hypertension in the absence of cardiopulmonary disease. Although the development of HH remains incompletely understood, the most acceptable explanation is that the pleural effusion is a result of a direct passage of ascitic fluid into the pleural cavity through a defect in the diaphragm due to the raised abdominal pressure and the negative pressure within the pleural space. Patients with HH can be asymptomatic or present with pulmonary symptoms such as shortness of breath, cough, hypoxemia, or respiratory failure associated with large pleural effusions...
December 27, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29274906/aptr-is-a-prognostic-marker-in-cirrhotic-patients-with-portal-hypertension-during-tips-procedure
#7
Shanshan Yu, Yanhua Qi, Jue Jiang, Hua Wang, Qi Zhou
Portal hypertension is a major cause of mortality and morbidity in cirrhotic patients. In this study, we aimed to analyze the clinical characteristics of Alu-mediated p21 transcriptional regulator (APTR) during transjugular intrahepatic portosystemic shunt (TIPS) procedure. Portal and hepatic venous blood was drawn from 84 patients with liver cirrhosis and portal hypertension before and after TIPS treatment. Then, we detected biochemical, hemodynamic parameters and APTR expression before and after TIPS treatment...
March 1, 2018: Gene
https://www.readbyqxmd.com/read/29261352/incrementally-expandable-transjugular-intrahepatic-portosystemic-shunts-single-center-experience
#8
Jie Cui, Sara E Smolinski, Fengyong Liu, Dihua Xu, Kal Dulaimy, Zubin Irani
OBJECTIVE: The purpose of this study is to investigate the long-term safety and efficacy of a small-diameter expandable transjugular intrahepatic portosystemic shunt (TIPS) in the management of portal hypertension. MATERIALS AND METHODS: This single-center retrospective study included 28 patients (12 women and 16 men; mean age, 56.9 years) who underwent small-diameter expandable TIPS creation between 2008 and 2010 for refractory ascites (n = 15; mean [± SD] model for end-stage liver disease [MELD] score, 15...
December 20, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29251274/interventional-endoscopic-ultrasound-a-new-promising-way-for-intrahepatic-portosystemic-shunt-with-portal-pressure-gradient
#9
Laurent Poincloux, Pascal Chabrot, Aurélien Mulliez, Julien Genes, Louis Boyer, Armando Abergel
BACKGROUND AND OBJECTIVES: Interventional endoscopic ultrasound (EUS) is a promising novel approach for intravascular interventions. The aim of this study was to assess the feasibility and safety of a EUS-guided intrahepatic portosystemic shunt (EGIPS) with portal pressure gradient measurement in a live porcine model. METHODS: The left hepatic vein (LHV) or the inferior vena cava (IVC) was punctured with a needle that advanced into the portal vein (PV). A guidewire was then inserted into the PV, and a needle knife was used to create an intrahepatic fistula between LHV and PV...
November 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/29245324/clinical-efficacy-of-transjugular-intrahepatic-portosystemic-shunt-in-the-treatment-of-hepatopulmonary-syndrome
#10
Hongwei Zhao, Fuquan Liu, Zhendong Yue, Lei Wang, Zhenhua Fan, Fuliang He
Transjugular intrahepatic portosystemic shunt (TIPS) reduces the portal venous pressure of patients with hepatopulmonary syndrome (HPS).To describe the patients who underwent TIPS for the treatment of HPS.A retrospective study was performed on 81 patients with HPS and gastrointestinal hemorrhage treated with TIPS. Thirty patients underwent TIPS through the main portal vein (group A), 24 through the left branch of the portal vein (group B), and 27 through the right branch of the portal vein (group C). The partial pressure of arterial oxygen (PaO2), alveolar-to-arterial oxygen partial pressure gradient (A-aPO2), oxygen saturation (SO2), and complications were recorded and compared...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29245287/an-inflammatory-myofibroblastic-tumor-in-the-transplanted-liver-displaying-quick-wash-in-and-wash-out-on-contrast-enhanced-ultrasound-a-case-report
#11
Jing Shang, Yun-Yue Wang, Ying Dang, Xin-Juan Zhang, Yan Song, Li-Tao Ruan
RATIONALE: Inflammatory myofibroblastic tumor (IMT) is an uncommon mesenchymal neoplasm, and its presence in a grafted liver is exceedingly rare. PATIENT CONCERNS: A 54-year-old woman was admitted to our hospital with a half-month history of intermittent melena. She had undergone deceased-donor liver transplantation (LT) for hepatitis B virus related liver cirrhosis without hepatocellular carcinoma 5 months previously. DIAGNOSIS: Laboratory examination showed impaired liver and renal functions and Epstein-Barr virus (EBV) infection, but tumor markers within normal ranges...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29245228/use-of-concomitant-variceal-embolization-and-prophylactic-antiplatelet-anticoagulative-in-transjugular-intrahepatic-portosystemic-shunting-a-retrospective-study-of-182-cirrhotic-portal-hypertension-patients
#12
Yingmei Tang, Sheng Zheng, Jinhui Yang, Weimin Bao, Lihong Yang, Yingchun Li, Ying Xu, Jing Yang, Yuyun Tong, Jinhang Gao, Chengwei Tang
Transjugular intrahepatic portosystemic shunting (TIPS) is an effective treatment modality for refractory variceal bleeding and ascites in patients with cirrhotic portal hypertension (CPH). Variceal rebleeding and shunt dysfunction are major post-TIPS morbidities. This study aimed to retrospectively evaluate the effectiveness and safety of use of concomitant variceal embolization and prophylactic antiplatelet/anticoagulative in patients with CPH undergoing TIPS. Between October 2006 and October 2011, 182 patients with CPH were retrospectively and consecutively hospitalized for elective TIPS with Fluency stenting...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29238588/the-role-of-tips-in-the-management-of-liver-transplant-candidates
#13
Lukas W Unger, Theresa Stork, Theresa Bucsics, Susanne Rasoul-Rockenschaub, Katharina Staufer, Michael Trauner, Svenja Maschke, Max Pawloff, Thomas Soliman, Thomas Reiberger, Gabriela A Berlakovich
Background: Transjugular intrahepatic portosystemic shunt (TIPS) implantation is used for treatment of several complications in patients with liver cirrhosis. Recent studies have identified a survival benefit for patients on the waiting list after TIPS implantation, but the optimal time point for TIPS implantation prior to orthotopic liver transplantation (OLT) has not been established. Study: This study retrospectively assessed patients undergoing TIPS implantation before or after listing for OLT at the Medical University of Vienna...
December 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29230112/clinical-images-transjugular-intrahepatic-portosystemic-shunt-reduction-for-management-of-recurrent-hepatic-encephalopathy
#14
Hafez Khalili, Daryl Goldman, Sarah Frischhertz, David Kirsch
No abstract text is available yet for this article.
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29216531/living-donor-liver-transplantation-for-adult-budd-chiari-syndrome-resection-without-replacement-of-retrohepatic-ivc-a-case-report
#15
Tarek Abdelazeem Sabra, Hideaki Okajima, Tetsuya Tajima, Ken Fukumitsu, Koichiro Hata, Kentaro Yasuchika, Toshihiko Masui, Kojiro Taura, Toshimi Kaido, Shinji Uemoto
INTRODUCTION: Suprahepatic caval resection and replacement of inferior vena cava (IVC) is standard procedure in deceased donor liver transplantation for patients with Budd-Chiari syndrome (BCS). However, replacement of IVC in living donor liver transplantation (LDLT) is difficult. We report a case of BCS successfully treated by LDLT without replacement of IVC. PRESENTATION OF CASE: A 52-years-old female with a primary BCS due to IVC thrombosis. A vena cava (VC) stent placed after angioplasty without improvement of the hepatic, portal venous flow and liver functions, Transjugular intrahepatic portosystemic shunt was considered and the patient had a rapid deterioration and increased ascites...
December 1, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29214793/mesocaval-shunt-creation-for-jejunal-variceal-bleeding-with-chronic-portal-vein-thrombosis
#16
Ja Kyung Yoon, Man Deuk Kim, Do Yun Lee, Seok Joo Han
The creation of transjugular intrahepatic portosystemic shunt (TIPS) is a widely performed technique to relieve portal hypertension, and to manage recurrent variceal bleeding and refractory ascites in patients where medical and/or endoscopic treatments have failed. However, portosystemic shunt creation can be challenging in the presence of chronic portal vein occlusion. In this case report, we describe a minimally invasive endovascular mesocaval shunt creation with transsplenic approach for the management of recurrent variceal bleeding in a portal hypertension patient with intra- and extrahepatic portal vein occlusion...
January 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29210304/current-management-of-refractory-ascites-in-patients-with-cirrhosis
#17
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...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29202584/treatment-of-acute-portomesenteric-venous-thrombosis-with-thrombectomy-through-a-transjugular-intrahepatic-portosystemic-shunt-a-single-center-experience
#18
Kerstin Rosenqvist, Charlotte Ebeling Barbier, Fredrik Rorsman, Per Sangfelt, Rickard Nyman
Background Acute portomesenteric venous thrombosis (PMVT) is a potentially life-threatening condition and urgent treatment is required. Purpose To retrospectively evaluate the efficacy and safety of treating acute PMVT by the creation of a transjugular intrahepatic portosystemic shunt (TIPS) followed by thrombectomy. Material and Methods Six patients (all men, age range = 39-51 years) presenting with acute PMVT were treated with transjugular thrombectomy (TT) through a TIPS created in the same session. The intervention included iterated venography through the TIPS one to three times within the first week after diagnosis and repeated thrombectomy if needed (n = 5)...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/29181605/symptomatic-heart-failure-after-transjugular-intrahepatic-portosystemic-shunt-placement-incidence-outcomes-and-predictors
#19
Kunjam Modha, Baljendra Kapoor, Rocio Lopez, Mark J Sands, William Carey
PURPOSE: To assess the incidence of symptomatic heart failure (SHF) occurring after transjugular intrahepatic portosystemic shunt (TIPS) placement, identify potential predictors of SHF, and evaluate clinical presentation and outcomes in cases of post-TIPS SHF. MATERIALS AND METHODS: A prospectively maintained TIPS database was used to identify patients who underwent new TIPS placements at a large urban tertiary care center between 1995 and 2014. SHF was defined as otherwise unexplained new-onset dyspnea, hypoxemia, radiologic pulmonary edema, an increased need for diuretics, or need for intubation within 7 days after TIPS placement...
November 27, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29154015/albumin-bilirubin-grade-versus-meld-score-for-predicting-survival-after-transjugular-intrahepatic-portosystemic-shunt-tips-creation
#20
J Ronald, Q Wang, S S Choi, P V Suhocki, M D Hall, T P Smith, C Y Kim
OBJECTIVES: The purpose of this study was to compare the albumin-bilirubin (ALBI) grade and model for end-stage liver disease (MELD) scores for predicting survival after transjugular intrahepatic portosystemic shunt (TIPS) creation. MATERIALS AND METHODS: A retrospective study of pre-procedure ALBI and MELD scores was performed in 197 patients who underwent TIPS from 2005 to 2012. There were 140 men and 57 women, with a mean age of 56±11 (SD) (range: 19-90years)...
November 16, 2017: Diagnostic and Interventional Imaging
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