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TIPS liver cirrhosis

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https://www.readbyqxmd.com/read/28057091/-resting-state-functional-magnetic-resonance-study-of-brain-function-changes-after-tips-operation-in-patients-with-liver-cirrhosis
#1
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
#2
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/27984174/emergency-tips-in-a-child-pugh-b-patient-when-does-the-window-of-opportunity-open-and-close
#3
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/27977618/covered-tips-for-secondary-prophylaxis-of-variceal-bleeding-in-liver-cirrhosis-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#4
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/27923694/neuropsychiatric-performance-in-patients-with-cirrhosis-who-is-normal
#5
REVIEW
Sara Montagnese, Michele De Rui, Paolo Angeli, Piero Amodio
Normal neuropsychiatric performance in cirrhosis has been traditionally defined by the absence of any degree of hepatic encephalopathy (HE) and/or the absence of psychometric or neurophysiological abnormalities, by comparison with reference data from the healthy population. It is our impression that as our understanding and management of end-stage liver disease continues to change, the concept of normal neuropsychiatric performance may also need updating. This review explores novel and possibly more pragmatic interpretations of neuropsychiatric "normality" by comparison with top personal performance, in terms of risk of overt HE/brain failure and in relation with events such as liver transplantation, decompensation, acute-on-chronic liver failure (ACLF) and Transjugular Intrahepatic Portal-systemic Shunt (TIPS) placement...
December 3, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27816756/sarcopenia-is-risk-factor-for-development-of-hepatic-encephalopathy-after-transjugular-intrahepatic-portosystemic-shunt-placement
#6
Silvia Nardelli, Barbara Lattanzi, Sabrina Torrisi, Francesca Greco, Alessio Farcomeni, Stefania Gioia, Manuela Merli, Oliviero Riggio
BACKGROUND & AIMS: Hepatic encephalopathy (HE) is an important complication in patients with cirrhosis who received transjugular intrahepatic portosystemic shunts (TIPS). We investigated whether a decrease in muscle mass was associated independently with the occurrence of HE after TIPS. METHODS: We performed a prospective study of 46 consecutive patients with cirrhosis (mean age, 58.6 ± 9.1 y; mean model for end-stage liver disease score, 11.3 ± 3.3; mean Child-Pugh score, 7...
November 2, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27723988/-late-complications-of-liver-cirrhosis-management-of-gastrointestinal-bleeding-in-the-presence-of-portal-hypertension
#7
Václav Hejda
Cirrhosis is the end stage of progressive development of different liver diseases and is associated with significant morbidity and mortality rates. Cirrhosis is associated with a number of potential complications, in particular with development of portal hypertension. Portal hypertension with the production of ascites, hepatic and gastric varices bleeding in the upper part of the gastrointestinal tract, presents the breakpoint in the natural course of cirrhosis, and it is associated with a considerably worse prognosis of patients, with a dramatically increased risk of mortality...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27706896/the-soluble-mannose-receptor-is-released-from-the-liver-in-cirrhotic-patients-but-is-not-associated-with-bacterial-translocation
#8
Tea L Laursen, Sidsel Rødgaard-Hansen, Holger J Møller, Christian Mortensen, Stine Karlsen, Dennis T Nielsen, Susanne Frevert, Jens O Clemmesen, Søren Møller, Jørgen S Jensen, Flemming Bendtsen, Henning Grønbaek
BACKGROUND & AIMS: Intestinal bacterial translocation is involved in activation of liver macrophages in cirrhotic patients. Macrophages play a key role in liver inflammation and are involved in the pathogenesis of cirrhosis and complications. Bacterial translocation may be determined by presence of bacterial DNA and macrophage activation, by the soluble mannose receptor. We hypothesize that the soluble mannose receptor is released from hepatic macrophages in cirrhosis and associated with bacterial DNA, portal pressure and complications...
October 5, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27706547/-percutaneous-paraumbilical-embolization-of-bleeding-rectal-varices-due-to-portal-hypertension
#9
T Stuber, B Schmitz, H J Brambs
Introduction: Portal hypertension may lead to severe esophageal or rectal variceal bleeding. Case report: We present a case of a 67-year-old patient presenting with recurrent rectal variceal bleeding who was non-responsive to endoscopic treatment. We are reporting on an interventional therapeutic approach found in interdisciplinary consensus. Discussion: Endoscopy, surgery or TIPS (transjugular intrahepatic portosystemic shunt) can be performed in patients with gastrointestinal bleeding due to portal hypertension in liver cirrhosis...
October 5, 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27706545/rescue-therapy-of-a-refractory-rectal-variceal-bleeding-in%C3%A2-a-cirrhotic-patient-by-linton-nachlas-tube-and-tips-implantation-in-combination-with-variceal-embolization
#10
Matthias Buechter, Jens M Theysohn, Alisan Kahraman, Paul Manka, Guido Gerken, Ali Canbay, Alexander Dechêne
Background Transjugular intrahepatic portosystemic shunt (TIPS) is considered the gold standard for treatment of gastrointestinal variceal bleeding refractory to endoscopic therapy in patients with portal hypertension. Clinically relevant hemorrhage from rectal varices is less frequent than from other sources, and the therapeutic role of TIPS is still ambiguous. Case report A 57-year-old female patient was referred to us in December 2015 with severe signs of decompensated alcohol-induced liver cirrhosis...
January 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27695164/safety-and-efficacy-of-2-octyl-cyanoacrylate-in-the-management-of-patients-with-gastric-and-duodenal-varices-who-are-not-candidates-for-transjugular-intrahepatic-portosystemic-shunts
#11
Luis Lizardo-Sanchez, James Burdick, James F Trotter
Gastric variceal bleeding is associated with significant morbidity and mortality in patients with portal hypertension and cirrhosis. Options are limited for patients who are not candidates for transjugular intrahepatic portosystemic shunts (TIPS). Cyanoacrylate injections have been reported to be efficacious in previous case series. The aim of this retrospective study was to report our single-center experience with the safety and efficacy of 2-octyl-cyanoacrylate in patients who were not TIPS candidates. Electronic medical records were reviewed for 16 patients who underwent a total of 18 esophagogastroduodenoscopies for acute gastric or duodenal variceal bleeding and secondary prophylaxis of gastric varices; 14 patients had cirrhosis with an average Model for End-Stage Liver Disease score of 16, and 2 patients had noncirrhotic portal hypertension...
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27663604/transjugular-intrahepatic-portosystemic-shunts-with-covered-stents-increase-transplant-free-survival-of-patients-with-cirrhosis-and-recurrent-ascites
#12
Christophe Bureau, Dominique Thabut, Frédéric Oberti, Sébastien Dharancy, Nicolas Carbonell, Antoine Bouvier, Philippe Mathurin, Philippe Otal, Pauline Cabarrou, Jean Marie Péron, Jean Pierre Vinel
BACKGROUND & AIMS: There is controversy over the ability of transjugular intrahepatic portosystemic shunts (TIPS) to increase survival times of patients with cirrhosis and refractory ascites. The high rate of shunt dysfunction with the use of uncovered stents counteracts the benefits of TIPS. We performed a randomized controlled trial to determine the effects of TIPS with stents covered with polytetrafluoroethylene in these patients. METHODS: We performed a prospective study of 62 patients with cirrhosis and at least 2 large-volume paracenteses within a period of at least 3 weeks; the study was performed at 4 tertiary care centers in France from August 2005 through December 2012...
January 2017: Gastroenterology
https://www.readbyqxmd.com/read/27620282/techniques-of-tips-in-the-treatment-of-liver-cirrhosis-combined-with-incompletely-occlusive-main-portal-vein-thrombosis
#13
Mengfei Zhao, Zhendong Yue, Hongwei Zhao, Lei Wang, Zhenhua Fan, Fuliang He, Jiannan Yao, Xiaoqun Dong, Fuquan Liu
The patients of liver cirrhosis associated with portal vein thrombosis (PVT) can be effectively treated by transjugular intrahepatic portosystemic stent shunt (TIPS). Although the corresponding TIPS procedures have already performed on the patients to different types of PVT, the procedures are not specific and the relationship between different types of PVT and technical success rate of TIPS is unclear. What's more, we aimed to explore the relationship between survival and vascular patency immediately after TIPS...
September 13, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27594947/transsplenic-portal-vein-reconstruction-transjugular-intrahepatic-portosystemic-shunt-in-a-patient-with-portal-and-splenic-vein-thrombosis
#14
Jason T Salsamendi, Francisco J Gortes, Michelle Shnayder, Mehul H Doshi, Ji Fan, Govindarajan Narayanan
Portal vein thrombosis (PVT) is a potential complication of cirrhosis and can worsen outcomes after liver transplant (LT). Portal vein reconstruction-transjugular intrahepatic portosystemic shunt (PVR-TIPS) can restore flow through the portal vein (PV) and facilitate LT by avoiding complex vascular conduits. We present a case of transsplenic PVR-TIPS in the setting of complete PVT and splenic vein (SV) thrombosis. The patient had a 3-year history of PVT complicated by abdominal pain, ascites, and paraesophageal varices...
September 2016: Radiology case reports
https://www.readbyqxmd.com/read/27553918/prospective-evaluation-of-passive-expansion-of-partially-dilated-transjugular-intrahepatic-portosystemic-shunt-stent-grafts-a-three-dimensional-sonography-study
#15
Claus Christian Pieper, Christian Jansen, Carsten Meyer, Jennifer Nadal, Jennifer Lehmann, Hans Heinz Schild, Jonel Trebicka, Daniel Thomas
PURPOSE: To prospectively investigate early expansion kinetics of underdilated self-expanding stent grafts used for transjugular intrahepatic portosystemic shunt (TIPS) creation. MATERIALS AND METHODS: Twenty patients (7 female; mean age 66 y; range, 31-80 y) with liver cirrhosis undergoing TIPS creation for variceal bleeding (n = 5), refractory ascites (n = 14), or both (n = 1) with underdilation of 10-mm stent grafts received two-dimensional (2-D) and three-dimensional (3-D) ultrasound (US) examinations immediately after TIPS creation and 1 and 6 weeks later...
January 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/27493114/%C3%A2-risk-factors-contributing-to-early-infection-following-transjugular-intrahepatic-portosystemic-shunt-in-perioperative-period
#16
Peng Deng, Biao Zhou, Xiao Li
UNLABELLED:  Introducción and aim. To investigate and identify the risk factors associated with early infection following a transjugular intrahepatic portosystemic shunt (TIPS)procedure in perioperative period. MATERIAL AND METHODS: The interventional radiology database at the West China Hospital in Sichuan, China was reviewed to identify all patients that underwent a TIPS procedure between January 30, 2013 and August 30, 2015. Four hundred and sixty-six TIPS patients with liver cirrhosis were enrolled in this study...
September 2016: Annals of Hepatology
https://www.readbyqxmd.com/read/27466874/single-port-totally-extraperitoneal-preperitoneal-hernia-repair-procedure-tips-and-our-experience
#17
Noriaki Kameyama, Norihiro Kishida, Yuki Seo, Satoshi Tabuchi, Toshiki Yamashita
Single-port laparoscopic surgery is gaining increased attention because of its superiority in terms of cosmesis. A 1.5 cm vertical transumbilical incision is used for the single port, which is created by the glove method. We began applying single-port surgery to hernia repair in 2010, at which time we used the transabdominal preperitoneal (TAPP) approach. We began applying the totally extraperitoneal peritoneal (TEP) approach in 2013. Single-port TEP repair is now our standard procedure for inguinal hernia repair, and we consider it to be indicated for all cases of inguinal hernia unless the hernia has occurred during pregnancy, the patient is assigned to American Society of Anesthesiologists (ASA) class 3/4, or ascites due to liver cirrhosis is present...
July 29, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27278239/ascites-in-children
#18
Ashish Bavdekar, Nitin Thakur
Ascites is an accumulation of serous fluid within the peritoneal cavity. It is the most common complication of liver cirrhosis. In children, hepatic, renal and cardiac disorders are the most common causes. Portal hypertension and sodium and fluid retention are key factors in the pathophysiology of ascites. Peripheral arterial vasodilatation hypothesis is the most accepted mechanism for inappropriate sodium retention and formation of ascites. Diagnostic paracentesis is indicated in children with newly diagnosed ascites and in children with suspected complications of ascites...
June 9, 2016: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27242207/-hepatic-hydrothorax
#19
Jean-François Cadranel, Armand Garioud, Hortensia Lison, Mourad Medmoun, Thierry Thevenot
Hydrothorax liver is defined by the presence of pleural effusion greater than 500mL secondary to portal hypertension in cirrhotic patients. Poor tolerance of hepatic hydrothorax makes the therapeutic management of these fragile patients and is associated with iatrogenic complications. The mechanism of hydrothorax formation cirrhosis is due to a unidirectional transfer of the abdominal ascites through the diaphragmatic gaps (that were identified macroscopically and microscopically) in the pleural cavity. The treatment of hepatic hydrothorax is determined by the possibility or not of liver transplantation...
October 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27194673/uncommon-cause-of-acute-encephalopathy-in-liver-cirrhosis
#20
Monique Dieuvil, John Malaty
A 49-year-old woman with a medical history of alcoholic cirrhosis status post-transjugular intrahepatic portosystemic shunt (post-TIPS) in 2012, and ongoing alcohol abuse, presented to the hospital, with haematuria. CT intravenous pyelogram (IVP) was normal except for 'a large intrahepatic cystic mass adjacent to the TIPS, causing intrahepatic biliary duct dilation'. The patient also presented with acute encephalopathy, jaundice, right upper quadrant abdominal pain and hyperbilirubinaemia (total bilirubin of 8...
May 18, 2016: BMJ Case Reports
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