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portal vein hypertension

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https://www.readbyqxmd.com/read/29214793/mesocaval-shunt-creation-for-jejunal-variceal-bleeding-with-chronic-portal-vein-thrombosis
#1
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/29211374/-splanchnic-vein-thrombosis
#2
Bobby Gouin, Helia Robert-Ebadi, Alessandro Casini, Yan Beauverd, Pierre Fontana, Marc Righini, Laure Elkrief
Splanchnic vein thromboses include thrombosis of the portal venous system (including the portal, mesenteric and splenic vein) and hepatic vein thrombosis (also called Budd-Chiari syndrome). They are rare manifestations of venous thromboembolism. These thromboses are frequently associated with local or systemic factors. The therapeutic approach is often complex due to heterogeneity of patients and limited available data in the literature. The cornerstone of treatment is anticoagulation. However, the bleeding risk, related to portal hypertension, should be accurately assessed to individualize the treatment...
December 6, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29205328/quantitative-analysis-of-hepatic-macro-and-microvascular-alterations-during-cirrhogenesis-in-the%C3%A2-rat
#3
Geert Peeters, Charlotte Debbaut, Adrian Friebel, Pieter Cornillie, Winnok H De Vos, Kasper Favere, Ingrid Vander Elst, Tim Vandecasteele, Tim Johann, Luc Van Hoorebeke, Diethard Monbaliu, Dirk Drasdo, Stefan Hoehme, Wim Laleman, Patrick Segers
Cirrhosis represents the end-stage of any persistent chronically active liver disease. It is characterized by the complete replacement of normal liver tissue by fibrosis, regenerative nodules, and complete fibrotic vascularized septa. The resulting angioarchitectural distortion contributes to an increasing intrahepatic vascular resistance, impeding liver perfusion and leading to portal hypertension. To date, knowledge on the dynamically evolving pathological changes of the hepatic vasculature during cirrhogenesis remains limited...
December 4, 2017: Journal of Anatomy
https://www.readbyqxmd.com/read/29201208/the-content-of-hydrogen-sulfide-in-plasma-of-cirrhosis-rats-combined-with-portal-hypertension-and-the-correlation-with-indexes-of-liver-function-and-liver-fibrosis
#4
Weiwei Wei, Chao Wang, Dongjian Li
The purpose of this study is to investigate the content of hydrogen sulfide (H2S) in plasma of cirrhosis rats combined with portal hypertension and the correlation with indexes of liver function and liver fibrosis. Thirty female Sprague-Dawley rats were randomly divided into normal control group (NC), liver cirrhosis group (LC) and cirrhosis + propargylglycine (PPG) group (LC+PPG). Cirrhosis and portal hypertension were induced by carbon tetrachloride. Rats in LC+PPG group were intraperitoneally injected with H2S synthase inhibitor PPG for one week...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29190873/-segmental-portal-hypertension-with-splenic-vein-thrombosis-caused-by-pancreatitis
#5
Luis Franco-Avilés, Federico I Hernández-Rocha, Ulises Mercado, Cristian G Malvido-Torres
BACKGROUND: Splenic vein thrombosis is a complication of pancreatic carcinoma, pancreatitis or pancreatic pseudocyst. It may lead to segmental portal hypertension and bleeding from gastric varices. CLINICAL CASE: A 31 year-old man was diagnosed with pancreatitis of two weeks of evolution and was referred to our hospital in 2013. He had a history of alcohol consumption. Physical examination showed no stigmata of liver cirrhosis. Laboratory analyses revealed hemoglobin 9...
November 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29183764/clinical-outcome-of-portal-vein-thrombosis-in-patients-with-digestive-cancers-a-large-ageo-multicenter-study
#6
Hélène Regnault, Sheik Emambux, Thierry Lecomte, Solene Doat, Marion Dhooge, Marie Besson, Olivier Dubreuil, Frederic Moryoussef, Christine Silvain, Jean-Baptiste Bachet, David Tougeron
INTRODUCTION: Management of portal vein thrombosis (PVT) in cancer patients remains discussed. AIMS: The objective of this multicenter retrospective study was to investigate the management and outcome of PVT in patients with digestive cancers other than hepatocellular carcinoma (HCC). METHOD: Main inclusion criteria were trunk or branch PVT in patients with locally advanced or metastatic digestive cancers. Predictive factors of bleeding and overall survival (OS) were evaluated in univariate and multivariate analysis...
November 16, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29183424/surgery-for-portal-hypertension-in-children-a-12-year-review
#7
N Patel, A Grieve, J Hiddema, J Botha, J Loveland
BACKGROUND: Portal hypertension is a common and potentially devastating condition in children. Notwithstanding advances in the nonsurgical management of portal hypertension, surgery remains an important treatment modality in select patients. We report here on our experience in the past 12 years. OBJECTIVES: To describe the profile of, indication for, and complications of shunt surgery in children with portal hypertension. METHODS: Twelve children underwent shunt surgery between 2005 and 2017...
November 6, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29177197/foam-sclerotherapy-during-shunt-surgery-for-portal-hypertension-and-varices
#8
Zhe Zhang, Xueming Chen, Chenyu Li, Hai Feng, Hongzhi Yu, Renming Zhu, Tianyou Wang
Objective: This preliminary study investigated the clinical safety and efficacy of foam sclerotherapy during shunt surgery to treat portal hypertension and gastroesophageal varices. Methods: Seven patients with confirmed portal hypertension and a variceal bleeding history underwent mesocaval shunt with simultaneous polidocanol foam injection into the varices. Computed tomography and endoscopic reviews were conducted within two weeks following the procedures and around six months later...
2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/29176370/percutaneous-transhepatic-y-shaped-stent-placement-in-portal-superior-mesenteric-vein-tumor-thrombosis-before-right-colectomy
#9
Antonio Pesce, Andrea Boncoraglio, Antonio Basile, Stefano Puleo
Portal-mesenteric tumor thrombosis represents a rare finding in patients with colorectal cancers. To our knowledge this is the first report of a patient diagnosed as having a wide stenosing right colon cancer with portal-superior mesenteric vein tumor thrombosis at the time of diagnosis, who was treated before surgery by positioning a percutaneous transhepatic Y-shaped stent through the main portal vein and the superior mesenteric vein. Percutaneous interventional procedures have gained worldwide acceptance for improving the symptoms of portal hypertension, because of their minimal invasiveness and high success rates with low number of complications...
November 15, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29162782/recurrent-early-coronary-stent-thrombosis-under-chronic-disseminated-intravascular-coagulation
#10
Yusuke Oba, Satoshi Hoshide, Tadayuki Mitama, Hajime Shinohara, Takahiro Komori, Tomoyuki Kabutoya, Yasushi Imai, Nobuhiko Ogata, Kazuomi Kario
A 62-year-old Japanese man presented with chest pain indicating that acute myocardial infarction had occurred. Eleven years earlier, he underwent a splenectomy due to idiopathic portal hypertension. Coronary angiography revealed diffuse stenosis, with calcification in the left anterior descending coronary artery (LAD). We performed a primary percutaneous coronary intervention (PCI). We deployed two drug-eluting stents with sufficient minimal cross-sectional stent area by intravascular ultrasound and thrombolysis in myocardial infarction (TIMI) 3 flow...
November 22, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29130338/colonic-hydrogen-sulfide-produces-portal-hypertension-and-systemic-hypotension-in-rats
#11
Tomasz Huc, Halina Jurkowska, Maria Wróbel, Kinga Jaworska, Maksymilian Onyszkiewicz, Marcin Ufnal
Hydrogen sulfide, a toxic gas, at low concentrations is also a biological mediator in animals. In the colon, hydrogen sulfide is produced by intestinal tissues and gut sulfur bacteria. Gut-derived molecules undergo liver metabolism. Portal hypertension is one of the most common complications contributing to the high mortality in liver cirrhosis. We hypothesized that the colon-derived hydrogen sulfide may affect portal blood pressure. Sprague-Dawley rats were maintained either on tap water (controls) or on water solution of thioacetamide to produce liver cirrhosis (CRH-R)...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29123879/direct-intrahepatic-portocaval-shunt-for-refractory-hepatic-hydrothorax-a-case-report
#12
Yo Kawahara, Yoshihiro Tanaka, Naoaki Isoi, Kohsuke Hatanaka, Kentaro Yamada, Masayoshi Yamamoto, Teppei Okamura, Tatsumi Kaji, Toshihisa Sakamoto, Daizoh Saitoh, Hisashi Ikeuchi
Case: A 64-year-old man with complaints of dyspnea and orthopnea secondary to a hepatic hydrothorax refractory to diuretic medication underwent the transjugular intrahepatic portosystemic shunt (TIPS) procedure to decrease the portal vein pressure. The TIPS procedure failed due to severe liver stiffness. Direct intrahepatic portocaval shunt (DIPS), a modified TIPS procedure that directly inserts a stent from the inferior vena cava to the portal vein, was successfully carried out. Outcome: The DIPS procedure significantly decreased the patient's pleural effusion and respiratory symptoms...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29122309/the-keys-to-successful-tips-in-patients-with-portal-vein-thrombosis-and-cavernous-transformation
#13
S Lombardo, J J Espejo, M E Pérez-Montilla, L J Zurera, Á González-Galilea
Portal vein thrombosis is a common complication in patients with cirrhosis. Anticoagulation involves a high risk of bleeding secondary to portal hypertension, so placing transjugular intrahepatic portosystemic shunts (TIPS) has become an alternative treatment for portal vein thrombosis. Three strategies for TIPS placement have been reported: 1) portal recanalization and conventional implantation of the TIPS through the jugular vein; 2) portal recanalization through percutaneous transhepatic/transsplenic) access; and (3) insertion of the TIPS between the suprahepatic vein and a periportal collateral vessel without portal recanalization...
November 6, 2017: Radiología
https://www.readbyqxmd.com/read/29113006/transjugular-portal-vein-recanalization-with-creation-of-intrahepatic-portosystemic-shunt-pvr-tips-in-patients-with-chronic-non-cirrhotic-non-malignant-portal-vein-thrombosis
#14
Christoph Klinger, Bettina Riecken, Arthur Schmidt, Andrea De Gottardi, Benjamin Meier, Jaime Bosch, Karel Caca
Purpose To determine safety and efficacy of transjugular portal vein recanalization with creation of intrahepatic portosystemic shunt (PVR-TIPS) in patients with chronic non-cirrhotic, non-malignant portal vein thrombosis (PVT). Methods This retrospective study includes 17 consecutive patients with chronic non-cirrhotic PVT (cavernous transformation n = 15). PVR-TIPS was indicated because of variceal bleeding (n = 13), refractory ascites (n = 2), portal biliopathy with recurrent cholangitis (n = 1), or abdominal pain (n = 1)...
November 7, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29105936/circulating-cxcl10-in-cirrhotic-portal-hypertension-might-reflect-systemic-inflammation-and-predict-aclf-and-mortality
#15
Jennifer M Lehmann, Karina Claus, Christian Jansen, Alessandra Pohlmann, Robert Schierwagen, Carsten Meyer, Daniel Thomas, Steffen Manekeller, Joan Claria, Christian P Strassburg, Christian Trautwein, Hermann E Wasmuth, Marie-Luise Berres, Jonel Trebicka
BACKGROUND & AIMS: CXCR% ligands play an important role in hepatic injury, inflammation and fibrosis. While CXCL9 and CXCL11 are associated with survival in patients receiving transjugular intrahepatic portosystemic shunt (TIPS), the role of CXCL10 in severe portal hypertension remains unknown. METHODS: A total of 89 cirrhotic patients were analysed. CXCL10 protein levels were measured in portal and hepatic blood at TIPS insertion and 2 weeks later in 24 patients...
November 6, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29094033/inferior-mesenteric-arteriovenous-fistula
#16
Seunghun Lee, Jooweon Chung, Byungkwon Ahn, Seunghyun Lee, Sunguhn Baek
Arteriovenous fistula (AVF) involving the inferior mesenteric artery and vein is very rare with only 33 cases described in the literature and may be of congenital or acquired (iatrogenic or traumatic) or idiopathic etiology. The pathophysiology of AVF that acts as a left-to-right shunt has accounted for clinical signs and symptoms associated with ischemic colitis, portal hypertension, and heart failure. A low incidence and nonspecific clinical signs and symptoms such as abdominal pain, thrill and mass, lower and upper gastrointestinal bleeding make it difficult to establish a diagnosis of inferior mesenteric AVF...
October 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29093528/therapeutic-sirna-targeting-endothelial-kdr-decreases-portosystemic-collateralization-in-portal-hypertension
#17
Javier Gallego, Ester Garcia-Pras, Marc Mejias, Nuria Pell, Ute Schaeper, Mercedes Fernandez
Development of portosystemic collateral vessels and gastroesophageal varices is responsible for the most serious clinical consequences of portal hypertension, but effective clinical therapies are limited. Here we developed and investigated the therapeutic potential of an innovative liposomally-formulated short-interfering RNA (siRNA) technology based on clinical stage components, capable to attenuate production of the endothelial kinase insert domain receptor (KDR), which controls portosystemic collateralization and contributes to disease progression and aggravation...
November 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29074483/transjugular-intrahepatic-portosystemic-shunt-impact-on-systemic-haemodynamics-and-renal-and-cardiac-function-in-patients-with-cirrhosis
#18
Troels Malte Busk, Flemming Bendtsen, Jørgen Hjelm Poulsen, Jens Otto Clemmesen, Fin Stolze Larsen, Jens Peter Goetze, Jens Schmidt Iversen, Magnus Thorsten Jensen, Rasmus Møgelvang, Erling Bjerregaard Pedersen, Jesper Noergaard Bech, Søren Møller
BACKGROUND AND AIMS: Transjugular intrahepatic portosystemic shunt (TIPS) alleviates portal hypertension and possibly increases central blood volume (CBV). Moreover, renal function often improves; however, its effects on cardiac function are unclear. The aims of our study were to examine the effects of TIPS on hemodynamics and renal and cardiac function in patients with cirrhosis. METHODS: In 25 cirrhotic patients, we analyzed systemic, cardiac, and splanchnic hemodynamics by catheterization of the liver veins and right heart chambers before and 1 week after TIPS...
October 26, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29070023/portal-vein-thrombosis-in-liver-cirrhosis-incidence-management-and-outcome
#19
Shunichiro Fujiyama, Satoshi Saitoh, Yusuke Kawamura, Hitomi Sezaki, Tetsuya Hosaka, Norio Akuta, Masahiro Kobayashi, Yoshiyuki Suzuki, Fumitaka Suzuki, Yasuji Arase, Kenji Ikeda, Hiromitsu Kumada
BACKGROUND: Portal vein thrombosis (PVT) is a serious complication in liver cirrhosis with portal hypertension. We examined the treatment, recurrence and prognosis of PVT in cirrhotic patients. METHODS: The study subjects were all 90 cirrhotic patients with PVT treated with danaparoid sodium (DS) at our department between July 2007 and September 2016. The mean age was 68 years and mean Child-Pugh score was 7. All patients received 2500 U/day of DS for 2 weeks, and repeated in those who developed PVT recurrence after the initial therapy...
October 25, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29066371/harmful-and-beneficial-effects-of-anti-coagulants-in-patients-with-cirrhosis-and-portal-vein-thrombosis
#20
Vincenzo La Mura, Simon Braham, Giulia Tosetti, Federica Branchi, Niccolò Bitto, Marco Moia, Anna Ludovica Fracanzani, Massimo Colombo, Armando Tripodi, Massimo Primignani
BACKGROUND & AIMS: Vitamin K antagonists (VKAs) promote recanalization of portal vein thrombosis (PVT) in patients with cirrhosis. However, the benefit of PVT recanalization might be offset by major and minor bleeding associated with use of anti-coagulants. We evaluated harmful and beneficial effects of VKA in patients with PVT and cirrhosis. METHODS: We performed a retrospective study of 63 consecutive patients with cirrhosis given anti-coagulants for a first detection of non-neoplastic PVT from 2003 to 2015 in Italy...
October 21, 2017: Clinical Gastroenterology and Hepatology
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