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Transjugular intrahepatic portosystemic shunt

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https://www.readbyqxmd.com/read/28647317/associations-of-systemic-sphingolipids-with-measures-of-hepatic-function-in-liver-cirrhosis-are-related-to-cholesterol
#1
Sabrina Krautbauer, Reiner Wiest, Gerhard Liebisch, Christa Buechler
Lipoprotein particles are composed of various lipid classes including cholesterol and sphingolipids, and are low in serum of patients with liver cirrhosis. Hepatic decompensation is associated with a further decline of lipoproteins. Aim of the present work was to evaluate whether ceramide and sphingomyelin species are similarly changed in patients with liver cirrhosis and whether these variations are related to systemic cholesterol levels. In a cohort of 45 patients suffering from liver cirrhosis, cholesteryl ester species and subsequently total cholesterol were identified to be negatively associated with model of end stage liver disease (MELD) score...
June 21, 2017: Prostaglandins & Other Lipid Mediators
https://www.readbyqxmd.com/read/28611269/the-role-of-tips-in-patients-with-refractory-ascites-and-portal-vein-thrombosis
#2
Paulina Chinchilla-López, Nashla Hamdan-Pérez, Jorge Guerrero-Ixtlahuac, Beatriz Barranco-Fragoso, Nahum Méndez-Sánchez
Nowadays the contraindication for Transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal vein thrombosis (PVT) had been modify. The experience and technology have reduce the complications for this procedure. We report a case of refractory ascites and portal vein thrombosis to emphasize the role of TIPS in the treatment for this condition.
August 1, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28611152/hepatic-vein-pressure-predicts-gfr-in-cirrhotic-patients-with-hemodynamic-kidney-dysfunction
#3
Neel Desai, Joel Neugarten, Mary Dominguez, Ladan Golestaneh
The role of "nephrocongestion" in hemodynamic renal disease is understudied. Intra-abdominal hypertension accompanies liver disease and renal disease. Our hypothesis states that in those patients with liver disease, hepatic vein pressure measured during a transjugular intrahepatic portosystemic shunt (TIPS) procedure reflects intra-abdominal pressure and predicts estimated glomerular filtration rate (eGFR). We gathered data from our clinical database and chart review on a cohort of cirrhotic patients who received TIPS at Montefiore as part of their clinical care between 2004 and 2014...
June 2017: Physiological Reports
https://www.readbyqxmd.com/read/28606758/transjugular-intrahepatic-portosystemic-shunt-in-a-patient-with-caroli-s-disease-and-portal-cavernoma
#4
Roberto Miraglia, Luigi Maruzzelli, Sarah Degiorgio, Angelo Luca
No abstract text is available yet for this article.
May 25, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28599314/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
#5
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...
May 24, 2017: Oncotarget
https://www.readbyqxmd.com/read/28577156/recanalization-of-tipss-via-transsplenic-puncture
#6
Abhinav Jain, Vinit Kahalekar, Shaji Marar, Deepak Gupta, Sangeet Sawrav, S Kiran, Akash Shukla
Transjugular intrahepatic portosystemic shunt (TIPSS) has important role in the management of Budd-Chiari syndrome (BCS). Stent dysfunction rate up to 80% at 2 years limits the use of TIPSS. Reintervention is required if shunt develops occlusion or stenosis. Different techniques have been reported for the catheterization of TIPSS in cases of an occluded stent. In those failing a standard transvenous approach, the Colapinto needle technique, a combined transvenous transhepatic approach or transplenic approaches have been described...
June 2, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28550512/duplex-ultrasound-versus-clinical-surveillance-in-the-prediction-of-tips-malfunction-placed-for-refractory-ascites-is-ultrasound-surveillance-useful
#7
Shamar Young, Patrick Scanlon, Prashant Sherestha, Jafar Golzarian, Tina Sanghvi
PURPOSE: Since the advent of expanded polytetrafluoroethylene-covered stents and the improved patency they confer for transjugular intrahepatic portosystemic shunt (TIPS), the need to perform ultrasound surveillance has been debated. Prior reports have failed to separately evaluate patients who had TIPS placed for refractory ascites and variceal bleeding. The difference in morbidity from TIPS malfunction between these cohorts argues for distinction between the two. This retrospective review aims to determine whether Duplex ultrasound or return of symptoms more accurately predicts TIPS dysfunction...
May 26, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28543980/multicenter-analysis-of-the-use-of-transjugular-intrahepatic-portosystemic-shunt-tips-for-management-of-mpn-associated-portal-hypertension
#8
Christopher R Reilly, Daria V Babushok, Karlyn Martin, Jerry L Spivak, Michael Streiff, Ranjeeta Bahirwani, Jeffrey Mondschein, Brady Stein, Alison Moliterno, Elizabeth O Hexner
BCR-ABL1-negative myeloproliferative neoplasms (MPNs) are clonal stem cell disorders defined by proliferation of one or more myeloid lineages, and carry an increased risk of vascular events and progression to myelofibrosis and leukemia. Portal hypertension (pHTN) occurs in 7-18% of MPN patients via both thrombotic and nonthrombotic mechanisms and portends a poor prognosis. Transjugular intrahepatic portosystemic shunt (TIPS) has been used in the management of MPN-associated pHTN; however, data on long-term outcomes of TIPS in this setting is limited and the optimal management of medically refractory MPN-associated pHTN is not known...
May 24, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28516271/three-dimensional-image-fusion-guidance-for-transjugular-intrahepatic-portosystemic-shunt-placement
#9
Vania Tacher, Arthur Petit, Haytham Derbel, Luigi Novelli, Manuel Vitellius, Fourat Ridouani, Alain Luciani, Alain Rahmouni, Christophe Duvoux, Chady Salloum, Mélanie Chiaradia, Hicham Kobeiter
INTRODUCTION: To assess the safety, feasibility and effectiveness of image fusion guidance with pre-procedural portal phase computed tomography with intraprocedural fluoroscopy for transjugular intrahepatic portosystemic shunt (TIPS) placement. MATERIALS AND METHODS: All consecutive cirrhotic patients presenting at our interventional unit for TIPS creation from January 2015 to January 2016 were prospectively enrolled. Procedures were performed under general anesthesia in an interventional suite equipped with flat panel detector, cone-beam computed tomography (CBCT) and image fusion technique...
May 17, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28515965/anatomic-variations-of-the-right-portal-vein-prevalence-imaging-features-and-implications-for-successful-transjugular-intrahepatic-portosystemic-shunt-creation
#10
Senthil S Gunasekaran, Ron C Gaba
Given the widespread use of transjugular intrahepatic portosystemic shunt (TIPS) creation for the treatment of portal hypertensive complications, a working knowledge of portal venous anatomy is critical for interventional radiologists. The right portal vein - which is most commonly accessed during TIPS - is subject to various anatomic variants that may potentially impact procedure success. This pictorial essay characterizes the anatomic patterns of the right portal vein branching in terms of type and frequency based on case series review...
2017: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/28515846/passive-expansion-of-sub-maximally-dilated-transjugular-intrahepatic-portosystemic-shunts-and-assessment-of-clinical-outcomes
#11
Michael C Hsu, Charles N Weber, S William Stavropoulos, Timothy W Clark, Scott O Trerotola, Richard D Shlansky-Goldberg, Michael C Soulen, Gregory J Nadolski
AIM: To assess for passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts (TIPS) and compare outcomes with maximally dilated TIPS. METHODS: Polytetrafluoroethylene covered TIPS (Viatorr) from July 2002 to December 2013 were retrospectively reviewed at two hospitals in a single institution. Two hundred and thirty patients had TIPS maximally dilated to 10 mm (mTIPS), while 43 patients who were at increased risk for hepatic encephalopathy (HE), based on clinical evaluation or low pre-TIPS portosystemic gradient (PSG), had 10 mm TIPS sub-maximally dilated to 8 mm (smTIPS)...
April 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28512687/added-value-of-covered-stents-in-transjugular-intrahepatic-portosystemic-shunt-a-large-single-center-experience
#12
Amar C Gupta, Weiping Wang, Chintan Shah, Mark J Sands, Jennifer Bullen, Erick M Remer, Pilar M Bayona, William Carey, Baljendra Kapoor
PURPOSE: Transjugular intrahepatic portosystemic shunts (TIPS) were historically placed using uncovered bare-metal stents. Current practice has now shifted toward the use of polytetrafluoroethylene (PTFE)-covered stents, given the improved primary patency seen with these stents. The aim of this study was to determine whether there is any added value, such as overall survival or stent patency, when using covered stents versus uncovered stents in TIPS placement in a large cohort. MATERIALS AND METHODS: From April 1995 to June 2012, a total of 744 consecutive adult patients underwent de novo TIPS placement (378 receiving uncovered stents, 366 receiving covered stents)...
May 16, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28510807/incidence-of-hepatic-encephalopathy-after-transjugular-intrahepatic-portosystemic-shunt-tips-according-to-its-severity-and-temporal-grading-classification
#13
Paolo Fonio, Andrea Discalzi, Marco Calandri, Andrea Doriguzzi Breatta, Laura Bergamasco, Silvia Martini, Antonio Ottobrelli, Dorico Righi, Giovanni Gandini
OBJECTIVES: To evaluate hepatic encephalopathy (HE) incidence after transjugular intrahepatic portosystemic shunt (TIPS) and classify by gravity and frequency. METHODS: This is a retrospective study of 75 patients with no previous episodes of HE who underwent TIPS between 2008 and 2014 with clinical follow-up after 6 and 12 months. Patient risk factors evaluated include age, INR (international normalized ratio), creatinine, bilirubin, and MELD score (Model for End-of-stage Liver Disease)...
May 16, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28506905/eight-millimeter-covered-tips-does-not-compromise-shunt-function-but-reduces-hepatic-encephalopathy-in-preventing-variceal-rebleeding
#14
Qiuhe Wang, Yong Lv, Ming Bai, Zhengyu Wang, Haibo Liu, Chuangye He, Jing Niu, Wengang Guo, Bohan Luo, Zhanxin Yin, Wei Bai, Hui Chen, Enxin Wang, Dongdong Xia, Xiaomei Li, Jie Yuan, Na Han, Hongwei Cai, Tao Li, Huahong Xie, Jielai Xia, Jianhong Wang, Hongbo Zhang, Kaichun Wu, Daiming Fan, Guohong Han
BACKGROUND AND AIMS: Currently, there are no recommendations in guidelines concerning the preferred diameter of stents for transjugular intrahepatic portosystemic shunt (TIPS) owing to the lack of adequate evidence. We therefore evaluated that compared with 10-mm stents, whether 8-mm stents would achieve similar shunt function with less hepatic encephalopathy (HE) and better liver function. METHODS: Cirrhotic patients were randomly assigned to receive TIPS with an 8-mm or 10-mm covered stent to prevent variceal rebleeding...
May 12, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28498107/ultrasound-assisted-thrombolysis-of-an-occluded-transjugular-portosystemic-shunt
#15
Nicholas Hilliard, Teik Choon See, Nadeem Shaida
Transjugular intrahepatic portosystemic shunt (TIPS) insertion is commonly performed for refractory ascites or variceal bleeding. However, TIPS dysfunction can be seen in both early and late settings, with shunt thrombosis a particular problem. Treatment of shunt dysfunction commonly involves angioplasty and re-lining, with or without embolectomy, mechanical thrombectomy, or thrombolysis. Ultrasound-assisted thrombolysis has been shown to be successful for treatment of pulmonary embolism, deep vein thrombosis, and peripheral arterial thromboembolism, but has not been described before for TIPS occlusion...
May 12, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28494541/-new-therapeutic-paradigm-and-concepts-for-patients-with-cirrhotic-refractory-ascites
#16
S Z Wang, H G Ding
The activation of renin-angiotensin-aldosterone-vasopressin system is a key factor in the formation of ascites due to splanchnic vasodilation in cirrhosis. In theory, aldosterone antagonists, contraction of blood vessels, vasopressin V2 receptor, and angiotensin receptor antagonists are important targets for the prevention and treatment of cirrhotic ascites. The 15%-20% of patients with cirrhotic ascites that show no response to at least one week's treatment with potent diuretics (spironolactone 160 mg/d combined with furosemide 80 mg/d) are considered to have refractory ascites...
April 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28494001/partial-spleen-embolization-reduces-the-risk-of-portal-hypertension-induced-upper-gastrointestinal-bleeding-in-patients-not-eligible-for-tips-implantation
#17
Matthias Buechter, Alisan Kahraman, Paul Manka, Guido Gerken, Alexander Dechêne, Ali Canbay, Axel Wetter, Lale Umutlu, Jens M Theysohn
INTRODUCTION: Upper gastrointestinal bleeding (UGIB) is a severe and life-threatening complication among patients with portal hypertension (PH). Covered transjugular intrahepatic portosystemic shunt (TIPS) is the treatment of choice for patients with refractory or recurrent UGIB despite pharmacological and endoscopic therapy. In some patients, TIPS implantation is not possible due to co-morbidity or vascular disorders. Spleen embolization (SE) may be a promising alternative in this setting...
2017: PloS One
https://www.readbyqxmd.com/read/28491877/nodular-regenerative-hyperplasia-a-case-of-rare-prognosis
#18
Mindy Lee, Manhal Izzy, Ashwin Akki, Kathryn Tanaka, Harmit Kalia
Introduction: Nodular regenerative hyperplasia (NRH) is a known etiology of noncirrhotic portal hypertension. Cases of biopsy-proven NRH in human immunodeficiency virus (HIV)-positive patients have been described. While these patients often have normal synthetic liver function, several reports described disease progression to liver failure. Case: We here present a 26-year-old woman with history of congenital HIV on antiretroviral therapy complicated by Pneumocystis carinii pneumonia at age 14. CD4 counts have been >300 with undetectable viral load...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28491181/tips-performed-in-a-patient-with-complete-portal-vein-thrombosis
#19
Ashwani Kumar Sharma, David Charles Kaufman
Portal vein thrombosis is common in cirrhotic patients and results in increased morbidity and mortality. Transjugular intrahepatic portosystemic shunt (TIPS) creation is a well-established therapy for refractory variceal bleeding and refractory ascites in patients who do not tolerate repeated large volume paracentesis. Experience and technical improvements have led to improved TIPS outcomes that have encouraged an expanded application. Complete portal vein thrombosis has come a long way from being a contraindication to an indication for TIPS procedure...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28491179/transhepatic-embolization-of-a-congenital-intrahepatic-portosystemic-shunt-for-the-treatment-of-hepatic-encephalopathy-in-a-noncirrhotic-patient-using-amplatzer-vascular-plug-device
#20
Rachel Ann Brader, Kyung Rae Kim
A 73-year-old male with no history of liver disease was hospitalized for weakness, confusion, ataxia, and new onset hepatic encephalopathy with hyperammonemia. After management with lactulose and rifaximin, his symptoms persisted, and he underwent transjugular liver biopsy. Biopsy showed normal liver, but a portosystemic shunt was incidentally identified on postbiopsy venogram. The patient underwent occlusion of the shunt with two Amplatzer vascular plugs and four Nester coils. Following embolization, the patient's symptoms resolved completely...
June 2017: Radiology case reports
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