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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
#1
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
#2
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
#3
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
#4
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
#5
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/%C3%A2-observational-cohort-study-of-hepatic-encephalopathy-after-transjugular-intrahepatic-portosystemic-shunt-tips
#6
Michaela Routhu, Vaclav Safka, Sunil Kumar Routhu, Tomas Fejfar, Vaclav Jirkovsky, Antonin Krajina, Eva Cermakova, Ladislav Hosak
:  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
https://www.readbyqxmd.com/read/28051160/lipopolysaccharide-induced-neutrophil-dysfunction-following-transjugular-intrahepatic-portosystemic-stent-shunt-tipss-insertion-is-associated-with-organ-failure-and-mortality
#7
Jane Macnaughtan, Rajeshwar P Mookerjee, Rajiv Jalan
Systemic lipopolysaccharide (LPS) is implicated in increasing mortality in patients with alcoholic hepatitis but the underlying mechanisms are not well characterised. The objective of this study was to characterise neutrophil function, LPS and cytokine concentrations within the splanchnic circulation of alcoholic cirrhotic patients undergoing TIPSS insertion for variceal haemorrhage and correlate this with outcome. 26 patients with alcoholic cirrhosis and variceal haemorrhage were studied prior to and 1-hour after TIPSS insertion...
January 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28027761/radiation-dose-reduction-during-transjugular-intrahepatic-portosystemic-shunt-implantation-using-a-new-imaging-technology
#8
C Spink, M Avanesov, T Schmidt, M Grass, G Schoen, G Adam, P Bannas, A Koops
OBJECTIVE: To compare patient radiation dose in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS) implantation before and after an imaging-processing technology upgrade. METHODS: In our retrospective single-center-study, cumulative air kerma (AK), cumulative dose area product (DAP), total fluoroscopy time and contrast agent were collected from an age- and BMI-matched collective of 108 patients undergoing TIPS implantation. 54 procedures were performed before and 54 after the technology upgrade...
January 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28003724/balloon-occluded-retrograde-transvenous-obliteration-brto-a-novel-method-of-control-of-bleeding-from-post-glue-ulcer-over-gastric-varices-report-of-two-cases-and-review-of-literature
#9
Ritesh Prajapati, Piyush Ranjan, Arun Gupta, Ajit K Yadav
Bleeding gastric varices (GV) are managed by cyanoacrylate glue injection with transjugular intrahepatic portosystemic shunt (TIPSS) as modality for treatment failure. Ulcer can form at the site of glue injection over GV and it can cause bleeding. Treatment approach for such bleed is not well described. Balloon-occluded retrograde transvenous obliteration (BRTO), TIPSS, and devascularization remain the treatment options in this scenario. BRTO is an endovascular procedure where a balloon catheter is inserted into a draining vein of GV, and the sclerosant can be injected into the varices through the catheter during balloon occlusion...
December 2016: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/27986115/eus-guided-intrahepatic-portosystemic-shunt-a-real-alternative-to-transjugular-intrahepatic-portalsystemic-shunt
#10
EDITORIAL
Jaime Bosch
No abstract text is available yet for this article.
January 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27984174/emergency-tips-in-a-child-pugh-b-patient-when-does-the-window-of-opportunity-open-and-close
#11
REVIEW
Jonel Trebicka
Transjugular intrahepatic portosystemic shunt (TIPS) is used to treat complications of cirrhosis such as variceal bleeding and refractory ascites, but it also bears the risk of liver failure, overt hepatic encephalopathy (HE) and cardiac decompensation. Variceal bleeding may be controlled using endoscopic and medical treatment in patients with compensated cirrhosis; in decompensated patients, however, TIPS improves survival. Therefore, an early TIPS (within 72h or if later, still early after bleeding) might improve the survival of patients by preventing an inflammatory response and bacterial translocation...
October 29, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27979668/time-harmonic-elastography-of-the-liver-is-sensitive-to-intrahepatic-pressure-gradient-and-liver-decompression-after-transjugular-intrahepatic-portosystemic-shunt-tips-implantation
#12
Heiko Tzschätzsch, Ingolf Sack, Stephan Rodrigo Marticorena Garcia, Selcan Ipek-Ugay, Jürgen Braun, Bernd Hamm, Christian E Althoff
We investigated the correlation between hepatic venous pressure gradient (HVPG) and liver shear wave speed (SWS) measured by multi-frequency time-harmonic ultrasound elastography (THE) before and after transjugular intrahepatic portosystemic shunt (TIPS) implantation. Ten patients with ascites, cirrhotic liver disease and portal hypertension were prospectively examined with invasive HVPG measurement and THE before and after TIPS implantation. HVPG and SWS decreased after TIPS placement from 20.4 ± 2.2 mmHg to 9...
December 12, 2016: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/27977618/covered-tips-for-secondary-prophylaxis-of-variceal-bleeding-in-liver-cirrhosis-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#13
Xingshun Qi, Yulong Tian, Wei Zhang, Haitao Zhao, Guohong Han, Xiaozhong Guo
BACKGROUND: In the era of bare stents, transjugular intrahepatic portosystemic shunt (TIPS) is the second-line choice of therapy for the prevention of variceal rebleeding in liver cirrhosis. In the era of covered stents, the role of TIPS should be re-evaluated. AIM: The aim of the study was to compare the outcomes of covered TIPS versus the traditional first-line therapy (i.e, drug plus endoscopic therapy) for the prevention of variceal rebleeding in liver cirrhosis...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27975051/pathological-predictors-of-shunt-stenosis-and-hepatic-encephalopathy-after-transjugular-intrahepatic-portosystemic-shunt
#14
Fuliang He, Shan Dai, Zhibo Xiao, Lei Wang, Zhendong Yue, Hongwei Zhao, Mengfei Zhao, Qiushi Lin, Xiaoqun Dong, Fuquan Liu
Background. Transjugular intrahepatic portosystemic shunt (TIPS) is an artificial channel from the portal vein to the hepatic vein or vena cava for controlling portal vein hypertension. The major drawbacks of TIPS are shunt stenosis and hepatic encephalopathy (HE); previous studies showed that post-TIPS shunt stenosis and HE might be correlated with the pathological features of the liver tissues. Therefore, we analyzed the pathological predictors for clinical outcome, to determine the risk factors for shunt stenosis and HE after TIPS...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27959638/comparison-of-vascular-plugs-and-pushable-coils-for-variceal-embolization-after-tips
#15
Ammar Sarwar, Anthony M Esparaz, Elliot B Tapper, Olga R Brook, Douglas Grunwald, Raza Malik, Muneeb Ahmed
OBJECTIVE: Transjugular intrahepatic portosystemic shunt (TIPS) with variceal embolization is routinely performed to treat variceal bleeding. Embolization using vascular plugs is reported, but outcomes are not known. Outcomes and material costs of embolization using vascular plugs and coils are compared. MATERIALS AND METHODS: A single center's medical records of TIPS procedures (May 2003-December 2014) with variceal embolization were reviewed. Twenty patients with vascular plug embolization (age [± SD], 50 ± 10 years; seven men and 13 women; median Model for End-Stage Liver Disease [MELD], 20; interquartile range [IQR], 14-23) were compared with an age-, sex-, and MELD-matched cohort who underwent coil embolization (age, 50 ± 9 years; seven men and 13 women; median MELD, 17; IQR, 15-19; p = 0...
December 13, 2016: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27959484/transjugular-intrahepatic-portosystemic-shunt
#16
(no author information available yet)
No abstract text is available yet for this article.
2016: Clinical Privilege White Paper
https://www.readbyqxmd.com/read/27939056/laparoscopic-myotomy-after-transjugular-intrahepatic-portosystemic-shunt-placement-and-embolization-of-gastroesophageal-varices-in-patients-with-achalasia-and-cirrhosis
#17
Unai de Andres Olabarria, Soledad Ugarte Sierra, Roberto Maniega Alba, Igor Alberdi San Roman, Francisco Javier Ibáñez Aguirre
No abstract text is available yet for this article.
December 8, 2016: Cirugía Española
https://www.readbyqxmd.com/read/27938554/-current-status-of-treatment-of-refractory-ascites-in-patients-with-liver-cirrhosis
#18
J Shao, L Zhang, G H Han, D M Fan
Ascites is a common clinical manifestation of cirrhotic portal hypertension, and about 60%-80% of cirrhotic patients develop the symptom of ascites within 10 years. Once ascites occurs, the 5-year survival rate is reduced from 80% to 50%. With the progression of liver diseases, approximately 5%-10% of patients with ascites develop refractory ascites, and the median survival time is only 6-12 months. This article reviews the definition and diagnosis of refractory ascites, evaluation of prognostic factors, and treatment regimens, including large-volume paracentesis combined with protein supplementation, transjugular intrahepatic portosystemic shunt, and liver transplantation...
October 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/27920646/successful-treatment-of-small-intestinal-bleeding-in-a-crohn-s-patient-with-noncirrhotic-portal-hypertension-by-transjugular-portosystemic-shunt-placement-and-infliximab-treatment
#19
Benjamin Heimgartner, Heather Dawson, Andrea De Gottardi, Reiner Wiest, Jan Hendrik Niess
Small intestinal bleeding in Crohn's disease patients with noncirrhotic portal hypertension and partial portal and superior mesenteric vein thrombosis is a life-threatening event. Here, a case is reported in which treatment with azathioprine may have resulted in nodular regenerative hyperplasia, portal hypertension and portal vein thrombosis. The 56-year-old patient with Crohn's disease developed nodular regenerative hyperplasia under treatment with azathioprine. He was admitted with severe bleeding. Gastroscopy showed small esophageal varices without bleeding stigmata...
September 2016: Case Reports in Gastroenterology
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
#20
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