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transjugular intrahepatic

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https://www.readbyqxmd.com/read/29050854/pretransplantation-portal-vein-recanalization-and-transjugular-intrahepatic-portosystemic-shunt-creation-for-chronic-portal-vein-thrombosis-final-analysis-of-a-61-patient-cohort
#1
Bartley Thornburg, Kush Desai, Ryan Hickey, Elias Hohlastos, Laura Kulik, Daniel Ganger, Talia Baker, Michael Abecassis, Juan C Caicedo, Daniela Ladner, Jonathan Fryer, Ahsun Riaz, Robert J Lewandowski, Riad Salem
PURPOSE: To report the final analysis of the safety and efficacy of portal vein (PV) recanalization (PVR) and transjugular intrahepatic portosystemic shunt (TIPS) creation (PVR-TIPS) in patients with PV thrombosis (PVT) in need of liver transplantation. MATERIALS AND METHODS: Sixty-one patients with cirrhosis and PVT underwent PVR-TIPS to improve transplantation candidacy. Median patient age was 58 years (range, 22-75 y), and median pre-TIPS Model for End-Stage Liver Disease score was 14 (range, 7-42)...
October 17, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29049129/transjugular-intrahepatic-portosystemic-shunt-placement-before-abdominal-intervention-in-cirrhotic-patients-with-portal-hypertension-lessons-from-a-pilot-study
#2
Nadim Fares, Marie-Angèle Robic, Jean-Marie Péron, Fabrice Muscari, Philippe Otal, Bertrand Suc, Jean-Pierre Vinel, Christophe Bureau
BACKGROUND: Abdominal interventions are usually contraindicated in patients with cirrhosis and portal hypertension because of increased morbidity and mortality. Decreasing portal pressure with transjugular intrahepatic portosystemic shunt (TIPS) may improve patient outcomes. We report our experience with patients treated by neoadjuvant TIPS to identify those who would most benefit from this two-step procedure. PATIENTS AND METHODS: All patients treated by dedicated neoadjuvant TIPS between 2005 and March 2013 in two tertiary referral hospitals were included...
October 18, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29026464/evaluation-of-doppler-ultrasonography-in-the-diagnosis-of-transjugular-intrahepatic-portosystemic-shunt-dysfunction-a-prospective-study
#3
Charlotte Nicolas, Amélie Le Gouge, Louis d'Alteroche, Jean Ayoub, Monica Georgescu, Vincent Vidal, Denis Castaing, Jean-Pierre Cercueil, Patrick Chevallier, Jérôme Roumy, Hervé Trillaud, Louis Boyer, Vincent Le Pennec, Christophe Perret, Bruno Giraudeau, Jean-Marc Perarnau, Stic-Tips Group
AIM: To prospectively evaluate the performance of Doppler-ultrasonography (US) for the detection of transjugular intrahepatic portosystemic shunt (TIPS) dysfunction within a multicenter cohort of cirrhotic patients. METHODS: This study was conducted in 10 french teaching hospitals. After TIPS insertion, angiography and liver Doppler-US were carried out every six months to detect dysfunction (defined by a portosystemic gradient ≥ 12 mmHg and/or a stent stenosis ≥ 50%)...
September 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28990812/transjugular-intrahepatic-portosystemic-shunt-treatment-of-variceal-bleeding-in-an-unselected-patient-population
#4
K Rosenqvist, R Sheikhi, R Nyman, F Rorsman, P Sangfelt, C Ebeling Barbier
OBJECTIVE: To evaluate transjugular intrahepatic portosystemic shunt (TIPS) in variceal bleeding in a clinical setting. MATERIALS AND METHODS: Retrospective review of 131 patients (116 with liver cirrhosis) treated with TIPS with covered stent grafts in a single centre from 2002 to 2016. RESULTS: Survival at 1 and 2 years was 70% and 57% in patents with, and 100% at 2 years in patients without liver cirrhosis, respectively. A high Child-Pugh score and severe hepatic encephalopathy (HE) within 12 months post-TIPS were related to increased mortality...
October 9, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28988356/image-guided-treatment-of-budd-chiari-syndrome-a-giant-leap-from-the-past-a-small-step-towards-the-future
#5
Qiuhe Wang, Guohong Han
Budd-Chiari syndrome (BCS) is a relatively rare vascular disease characterized by hepatic outflow tract obstruction, and image-guided endovascular treatment, namely percutaneous angioplasty, stenting, and transjugular intrahepatic portosystemic shunt (TIPS), has proven to be effective treatment modalities to alleviate symptoms and markedly improve the prognosis of the disease. Specifically, a step-wise approach is recommended, i.e., angioplasty and stenting are the prioritized choice for patients with membranous obstruction and short-length stenosis, whereas TIPS is the option for patients who fail this treatment...
October 7, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28970291/covered-tips-versus-endoscopic-band-ligation-plus-propranolol-for-the-prevention-of-variceal-rebleeding-in-cirrhotic-patients-with-portal-vein-thrombosis-a-randomised-controlled-trial
#6
Yong Lv, Xingshun Qi, Chuangye He, Zhengyu Wang, Zhanxin Yin, Jing Niu, Wengang Guo, Wei Bai, Hongbo Zhang, Huahong Xie, Liping Yao, Jianhong Wang, Tao Li, Qiuhe Wang, Hui Chen, Haibo Liu, Enxing Wang, Dongdong Xia, Bohan Luo, Xiaomei Li, Jie Yuan, Na Han, Ying Zhu, Jielai Xia, Hongwei Cai, Zhiping Yang, Kaichun Wu, Daiming Fan, Guohong Han
OBJECTIVE: Limited data are available on the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis (PVT). This study aimed to compare transjugular intrahepatic portosystemic shunt (TIPS) with covered stents versus endoscopic band ligation (EBL) plus propranolol for the prevention of variceal rebleeding among patients with cirrhosis and PVT. DESIGN: Consecutive cirrhotic patients (94% Child-Pugh class A or B) with PVT who had variceal bleeding in the past 6 weeks were randomly assigned to TIPS group (n=24) or EBL plus propranolol group (EBL+drug, n=25), respectively...
September 28, 2017: Gut
https://www.readbyqxmd.com/read/28953093/brain-white-matter-fiber-tracts-involved-in-post-transjugular-intrahepatic-portosystemic-shunt-hepatic-myelopathy
#7
Liu-Xian Wang, Li Guo, Fan Guo, Shu-Yao Ren, Ning-Bo Fei, Kang Liu, Lin Liu, Tian-Lei Yu, Chuang-Ye He, Yi-Bin Xi, Ping Tian, Long-Biao Cui, Zhan-Xin Yin, Zheng-Yu Wang, Wei Qin, Guo-Hong Han, Hong Yin
We aimed to detect alterations in diffusion characteristics of brain white matter in hepatic myelopathy (HM) patients. Liver cirrhosis patients with (n=25) and without (n=18) HM after transjugular intrahepatic portosystemic shunt and 26 healthy controls were enrolled in this study. All participants were scanned with diffusion tensor imaging on a 3T Siemens scanner. Tract-based spatial statistics analysis was used to detect abnormalities of intracranial white matter tracts. Correlations between clinical characteristics and diffusion metrics were also calculated...
September 25, 2017: Neuroreport
https://www.readbyqxmd.com/read/28940225/treatment-of-refractory-ascites-with-an-automated-low-flow-ascites-pump-in-patients-with-cirrhosis
#8
G Stirnimann, T Berg, L Spahr, S Zeuzem, S McPherson, F Lammert, F Storni, V Banz, J Babatz, V Vargas, A Geier, A Stallmach, C Engelmann, C Trepte, J Capel, A De Gottardi
BACKGROUND: Refractory ascites (RA) is a frequent complication of cirrhosis, requiring large volume paracentesis or placement of a transjugular intrahepatic portosystemic shunt (TIPSS). The automated low-flow ascites pump (alfapump, Sequana Medical AG, Zurich, Switzerland) is an innovative treatment option for patients with RA. AIM: To assess safety and efficacy of this treatment in patients with a contraindication to TIPSS. METHODS: Fifty-six patients (43 males; mean age 62 years) from centres in Germany, Switzerland, UK and Spain were included and followed for up to 24 months...
September 21, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28932502/ultrasound-guided-direct-intrahepatic-portosystemic-shunt-in-patients-with-budd-chiari-syndrome-short-and-long-term-results
#9
Adam Hatzidakis, Nikolaos Galanakis, Elias Kehagias, Dimitrios Samonakis, Mairi Koulentaki, Erminia Matrella, Dimitrios Tsetis
BACKGROUND AND AIMS: Budd-Chiari syndrome (BCS) is treated with anticoagulation therapy, transjugular intrahepatic portosystemic shunt (TIPS), angioplasty, and liver transplantation. TIPS is not always technically feasible, due to the complete hepatic venous thrombosis. Direct intrahepatic portosystemic shunt (DIPS) is an alternative method for decompression of portal hypertension. This is a retrospective, single-center study aiming to evaluate the outcome of ultrasound (US)-guided DIPS in patients with BCS...
June 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28925475/percutaneous-implant-of-denver-peritoneo-venous-shunt-for-treatment-of-refractory-ascites-a-single-center-retrospective-study
#10
M Piccirillo, L Rinaldi, M Leongito, A Amore, A Crispo, V Granata, P Aprea, F Izzo
OBJECTIVE: Refractory ascites is defined as a lack of response to high doses of diuretics or the development of diuretic related side effects, which compel the patient to discontinue the diuretic treatment. Current therapeutic strategies include repeated large-volume paracentesis and transjugular intrahepatic portosystemic shunts (TIPS). Peritoneovenous shunt (Denver shunt) should be considered for patients with refractory ascites who are not candidates for paracentesis or TIPS. This study presents our case series in the implant of Denver peritoneovenous shunt...
August 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28915680/combination-therapy-versus-pharmacotherapy-endoscopic-variceal-ligation-or-the-transjugular-intrahepatic-portosystemic-shunt-alone-in-the-secondary-prevention-of-esophageal-variceal-bleeding-a-meta-analysis-of-randomized-controlled-trials
#11
Lu-Lu Lin, Shi-Ming Du, Yan Fu, Hui-Yun Gu, Lei Wang, Zhi-Yuan Jian, Xian-Feng Shen, Jie Luo, Chao Zhang
Patients with liver cirrhosis and variceal hemorrhage are at increased risk of rebleeding. We performed a meta-analysis toassess the clinical efficacy of combination therapy (pharmacotherapy and endoscopic variceal ligation (EVL)) compared with pharmacotherapy, EVL, or transjugular intrahepatic portosystemic shunt (TIPS) alone in the prevention of rebleeding and mortality. A literature search of MEDLINE, EMBASE, and the Cochrane Controlled Trials Register, up until November 2016, identified relevant randomized controlled trials...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28893712/single-session-percutaneous-endovascular-mesocaval-shunt-creation-and-balloon-occluded-retrograde-transvenous-obliteration-for-the-treatment-of-gastric-varices
#12
Ravi Nara Srinivasa, Bill S Majdalany, Jeffrey Forris Beecham Chick, J Matthew Meadows, Jordan Bruce Fenlon, Charles Brewerton, Wael E Saad
In the setting of portal hypertension, the body responds by creating portosystemic venous shunts which may lead to the development of varices. Endoscopic treatment of these varices is often warranted to prevent catastrophic bleeding. During the course of variceal treatment, one or more portosystemic shunts may be sacrificed which may acutely exacerbate portal hypertension and reduce systemic venous return. This report describes percutaneous creation of a mesocaval shunt and balloon-occluded retrograde transvenous obliteration (BRTO) in a patient with cavernous transformation of the portal vein...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28892178/review-article-the-diagnostic-approach-and-current-management-of-chylous-ascites
#13
REVIEW
B Lizaola, A Bonder, H D Trivedi, E B Tapper, A Cardenas
BACKGROUND: Chylous ascites is rare, accounting for less than 1% of cases. An appropriate and stepwise approach to its diagnosis and management is of key importance. AIM: To review the current diagnostic approach and management of chylous ascites. METHODS: A literature search was conducted using PubMed using the key words 'chylous', 'ascites', 'cirrhosis', 'pathophysiology', 'nutritional therapy', 'paracentesis", "transjugular intrahepatic portosystemic shunt" and "TIPSS'...
November 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28883536/techniques-and-long-term-effects-of-transjugular-intrahepatic-portosystemic-shunt-on-liver-cirrhosis-related-thrombotic-total-occlusion-of-main-portal-vein
#14
Lei Wang, Fuliang He, Zhendong Yue, Hongwei Zhao, Zhenhua Fan, Mengfei Zhao, Bin Qiu, Jiannan Yao, Qiushi Lin, Xiaoqun Dong, Fuquan Liu
Portal vein hypertension (PVH) in liver cirrhosis complicated with portal venous thrombosis (PVT) has been mainly treated with transjugular intrahepatic portosystemic shunt (TIPS). The clinical effects of TIPS have been confirmed, however, no large-scale studies have been focused on technical analyses and a long-term follow-up, especially on thrombotic total occlusion of main portal vein (MPV). To demonstrate critical techniques and clinical outcome of TIPS on liver cirrhosis-related thrombotic total occlusion of MPV, 98 patients diagnosed with liver cirrhosis related thrombotic total occlusion of MPV and treated with TIPS from January 2000 to January 2010 were retrospectively analyzed...
September 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28869158/re-bleeding-rates-and-survival-after-early-transjugular-intrahepatic-portosystemic-shunt-tips-in-clinical-practice
#15
Theresa Bucsics, Maria Schoder, Nicolas Goeschl, Philipp Schwabl, Mattias Mandorfer, Magdalena Diermayr, Maria Feldner, Florian Riedl, David Bauer, Bernhard Angermayr, Manfred Cejna, Arnulf Ferlitsch, Wolfgang Sieghart, Michael Trauner, Markus Peck-Radosavljevic, Josef Karner, Franz Karnel, Thomas Reiberger
BACKGROUND: Early implantation (<72h) of a transjugular intrahepatic portosystemic shunt (TIPS) after acute variceal bleeding (AVB) improves survival in highly selected patients. METHODS: We retrospectively assessed bleeding control and survival of unselected cirrhotic patients undergoing early TIPS implantation within 72h. We compared the outcomes to patients meeting early TIPS criteria but receiving late TIPS within 3-28days after AVB and endoscopic/medical treatment...
August 8, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28855918/effects-of-a-long-acting-formulation-of-octreotide-on-patients-with-portal-hypertension
#16
Pei-Jing Cui, Jing Yao, Yin Zhu, Zheng-Yun Zhang, Jun Yang
OBJECTIVE: This study aimed to determine whether the treatment of a long-acting formulation of octreotide (OCT-LAR) exerted a similar effect on improving the prognosis of patients with portal hypertension compared with placement of transjugular intrahepatic portosystemic shunts (TIPSs). METHODS: A total of 24 patients with portal hypertension who underwent TIPS placement or OCT-LAR treatment from January 2010 to January 2015 were reviewed. Hemodynamic studies, biological values, live functions, and treatment complications before and during the treatment were evaluated...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28852523/variceal-bleeding-in-cirrhotic-patients
#17
REVIEW
Maxime Mallet, Marika Rudler, Dominique Thabut
Variceal bleeding is one of the major causes of death in cirrhotic patients. The management during the acute phase and the secondary prophylaxis is well defined. Recent recommendations (2015 Baveno VI expert consensus) are available and should be followed for an optimal management, which must be performed as an emergency in a liver or general intensive-care unit. It is based on the early administration of a vasoactive drug (before endoscopy), an antibiotic prophylaxis and a restrictive transfusion strategy (hemoglobin target of 7 g/dL)...
August 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28843589/hemorrhage-risk-with-transjugular-intrahepatic-portosystemic-shunt-tips-insertion-at-the-main-portal-vein-bifurcation-with-stent-grafts
#18
A S Griffin, S R Preece, J Ronald, T P Smith, P V Suhocki, C Y Kim
PURPOSE: The purpose of this study was to assess the incidence of major hemorrhage after transjugular intrahepatic portosystemic shunt (TIPS) insertion using a stent graft at the main portal vein bifurcation. PATIENTS AND METHODS: TIPS insertion using stent grafts was performed in 215 patients due to non-variceal hemorrhage indications. There were 137 men and 78 women, with a mean age of 57 years±10.6 (SD) (range: 19-90 years). Based on retrospective review of portal venograms, TIPS inserted within 5mm from the portal vein bifurcation were considered "bifurcation TIPS", while those inserted 2cm or greater from the bifurcation were considered intrahepatic...
August 23, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28836115/management-of-ascites-and-hepatorenal-syndrome
#19
REVIEW
Salvatore Piano, Marta Tonon, Paolo Angeli
Ascites represents the most common decompensating event in patients with liver cirrhosis. The appearance of ascites is strongly related to portal hypertension, which leads to splanchnic arterial vasodilation, reduction of the effective circulating volume, activation of endogenous vasoconstrictor systems, and avid sodium and water retention in the kidneys. Bacterial translocation further worsens hemodynamic alterations of patients with cirrhosis and ascites. The first-line treatment of uncomplicated ascites is a moderate sodium-restricted diet combined with diuretic treatment...
August 23, 2017: Hepatology International
https://www.readbyqxmd.com/read/28814595/bleeding-ectopic-duodenal-varix-use-of-a-new-microvascular-plug-mvp-device-along-with-transjugular-intrahepatic-portosystemic-shunt-tipss
#20
Richa Bhardwaj, Gaurav Bhardwaj, Erik Bee, Raffi Karagozian
Ectopic varices (ECV) occur along the gastrointestinal (GI) tract outside the common variceal sites and represent 2%-5% of all GI variceal bleeds with mortality rates up to 40%. Management is challenging because of inaccessibility and increased risk of rebleeding. We report what is to our knowledge the first clinical use of a new microvascular plug (MVP) with transjugular intrahepatic portosystemic shunt (TIPSS) for a bleeding duodenal varix (DV). A 68-year-old man presented with melena. Endoscopy demonstrated a grade II varix in the second part of the duodenum with red wale sign...
August 16, 2017: BMJ Case Reports
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