3,516 results match your criteria Transjugular Intrahepatic Portosystemic Shunt


Budd-Chiari Syndrome in Behçet's Disease successfully managed with immunosuppressive and anticoagulant therapy: A case report and literature review.

Intractable Rare Dis Res 2019 Feb;8(1):60-66

Venous Thromboembolism Unit, Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

Behçet's Disease (BD) is a rare, chronic and recurrent inflammatory multisystemic condition of unknown origin that can affect any tissue. The vascular system is involved in 5-40% of cases of BD, including venous and arterial beds and it has a relapsing course. Budd-Chiari syndrome (BCS) is a rare complication of BD with a frequency of < 5% among patients with vascular involvement and is more frequent in men (89. Read More

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http://dx.doi.org/10.5582/irdr.2018.01128DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409111PMC
February 2019

Targeted puncture of left branch of intrahepatic portal vein in transjugular intrahepatic portosystemic shunt to reduce hepatic encephalopathy.

World J Gastroenterol 2019 Mar;25(9):1088-1099

Department of Ultrasound, Air Force Medical Center of PLA, Beijing 100142, China.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is currently used for the treatment of complications of portal hypertension. The incidence of hepatic encephalopathy (HE) remains a problem in TIPS placement. It has been reported that the right branch mainly receives superior mesenteric venous blood while the left branch mainly receives blood from the splenic vein. Read More

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http://dx.doi.org/10.3748/wjg.v25.i9.1088DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406189PMC
March 2019
1 Read

Treatment of aortic thrombosis with retrievable stent filter and thrombolysis: a case report.

BMC Cardiovasc Disord 2019 Mar 5;19(1):54. Epub 2019 Mar 5.

Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, No.1, East Jian She Road, Zhengzhou, 450052, China.

Background: The retrievable stent filter (RSF) has been previously used for the treatment of vena cava thrombosis. In this study, the RSF was implanted to treat aortic thrombosis and then withdrawn.

Case Presentation: A 47-years-old woman presented with severe abdominal pain and fever. Read More

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http://dx.doi.org/10.1186/s12872-019-1037-zDOI Listing

Lower 90-day Hospital Readmission Rates for Esophageal Variceal Bleeding After TIPS: A Nationwide Linked Analysis.

J Clin Gastroenterol 2019 Feb 27. Epub 2019 Feb 27.

Department of Medicine, Division of Gastroenterology, London Health Sciences Center.

Objective: Hospital readmission rates following a transjugular intrahepatic portosystemic shunt (TIPS) insertion after an episode of esophageal variceal bleeding (EVB) has not been well studied. We aimed to address this gap in knowledge on a population level.

Methods: The Nationwide Readmission Database (NRD) was used to study the readmission rates for patients with decompensated cirrhosis who had a TIPS insertion performed for EVB. Read More

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http://dx.doi.org/10.1097/MCG.0000000000001199DOI Listing
February 2019
1 Read

Review article: a multidisciplinary approach to the diagnosis and management of Budd-Chiari syndrome.

Aliment Pharmacol Ther 2019 Apr 3;49(7):840-863. Epub 2019 Mar 3.

Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

Background: Budd-Chiari syndrome (BCS) is a rare but fatal disease caused by obstruction in the hepatic venous outflow tract.

Aim: To provide an update of the pathophysiology, aetiology, diagnosis, management and follow-up of BCS.

Methods: Analysis of recent literature by using Medline, PubMed and EMBASE databases. Read More

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http://dx.doi.org/10.1111/apt.15149DOI Listing
April 2019
1 Read

Transjugular Intrahepatic Portosystemic Shunt does not affect the efficacy and safety of direct-acting antivirals in patients with advanced cirrhosis: A real-life, case-control study.

Dig Liver Dis 2019 Feb 7. Epub 2019 Feb 7.

Department of Experimental and Clinical Medicine, University of Florence, Italy; Research Center Denothe, University of Florence, Italy. Electronic address:

Background: Transjugular Intrahepatic Portosystemic Shunt (TIPS) is a well-established treatment for complications of portal hypertension.

Aims: To analyze the impact of TIPS on virologic response and safety profile in patients treated with direct-acting antivirals (DAAs).

Methods: We analyzed data from HCV-positive cirrhotic patients treated with DAAs. Read More

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http://dx.doi.org/10.1016/j.dld.2018.11.015DOI Listing
February 2019
1 Read

TIPSS for variceal bleeding in patients with idiopathic non-cirrhotic portal hypertension: comparison with patients who have cirrhosis.

Aliment Pharmacol Ther 2019 Apr 28;49(7):926-939. Epub 2019 Feb 28.

Department of Liver Diseases and Digestive Interventional Radiology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.

Background: In patients with idiopathic non-cirrhotic portal hypertension (INCPH), the usual recommended strategy for management of variceal bleeding is the same as that in cirrhosis. However, this policy has been challenged by the different natural history between INCPH and cirrhosis.

Aim: To compare outcomes after transjugular intrahepatic portosystemic shunt (TIPSS) between INCPH and cirrhotic patients admitted for variceal bleeding. Read More

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http://dx.doi.org/10.1111/apt.15186DOI Listing
April 2019
1 Read

Original Study: Transjugular Intrahepatic Portosystemic Shunt as a Bridge to Abdominal Surgery in Cirrhotic Patients.

J Gastrointest Surg 2019 Feb 28. Epub 2019 Feb 28.

Department of Digestive Surgery, Hepatobiliary Surgery and Liver Transplantation, University Hospital of Tours, CHU Tours, Avenue de la République, F37042, Tours, France.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) has been suggested to reduce portal hypertension-associated complications in cirrhotic patients undergoing abdominal surgery. The aim of this study was to compare postoperative outcome in cirrhotic patients with and without specific preoperative TIPS placement, following elective extrahepatic abdominal surgery.

Methods: Patients were retrospectively included from 2005 to 2016 in four centers. Read More

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http://dx.doi.org/10.1007/s11605-018-4053-xDOI Listing
February 2019
2 Reads

Parallel transjugular intrahepatic portosystemic shunt with Viatorr stents for primary TIPS insufficiency: Case series and review of literature.

World J Hepatol 2019 Feb;11(2):217-225

Department of Radiology, University of Kentucky, Lexington, KY 40536, United States.

Background: Transjugular intrahepatic portosystemic shunts (TIPS) can alleviate complications of portal hypertension such as ascites and variceal bleeding by decreasing the portosystemic gradient. In limited clinical situations, parallel TIPS may be only solution to alleviate either variceal bleeding or ascites secondary to portal hypertension when the primary TIPS fails to do so. Data specifically addressing the use of this partially polytetrafluoroethylene covered nitinol stent (Viatorr) is largely lacking despite Viatorr being the current gold standard for modern TIPS placement. Read More

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http://dx.doi.org/10.4254/wjh.v11.i2.217DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6393714PMC
February 2019
1 Read

Long-term patency and clinical outcome of the transjugular intrahepatic portosystemic shunt using the expanded polytetrafluoroethylene stent-graft.

PLoS One 2019 27;14(2):e0212658. Epub 2019 Feb 27.

Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, China.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) creation is an established treatment option to management the complications of portal hypertension. Recent data on the long-term outcomes of TIPS are scarce.

Materials And Methods: In this single-institution retrospective study, 495 patients underwent TIPS with the Fluency stent-grafts between December 2011 and June 2015 were evaluated. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0212658PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392293PMC
February 2019
2 Reads

Role of Interventional Radiology in Complications of Portal Hypertension.

J Clin Gastroenterol 2019 Feb 22. Epub 2019 Feb 22.

Department of Radiology, Division of Interventional Radiology.

Portal hypertension, a consequence of end-stage liver disease and liver cirrhosis can lead to significant morbidity and mortality for patients through abnormal fluid accumulation as well as the formation of portosystemic shunts and varices. Treatment of the sequelae of portal hypertension can be achieved through endovascular management by referral to an interventional radiologist on an outpatient or emergent basis as required. Current techniques include the placement of peritoneovenous shunts and tunneled peritoneal drains, the creation of transjugular intrahepatic portosystemic shunts, or the obliteration of shunts via balloon-occluded retrograde transvenous obliteration (BRTO). Read More

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http://dx.doi.org/10.1097/MCG.0000000000001180DOI Listing
February 2019
1 Read
3.498 Impact Factor

AngioJet-assisted transvenous-transhepatic mechanical thrombectomy in the portal vein.

Pol J Radiol 2018 28;83:e536-e544. Epub 2018 Dec 28.

University of Bonn, Germany.

Purpose: To evaluate AngioJet-assisted transvenous portal vein (PV) thrombectomy for non-cirrhotic patients with total portal vein and mesenteric vein thrombosis (PVMVT).

Material And Methods: From 2015 to 2016 four patients (3 male, mean 43.9 years, range 33-52 years) with acute (3 cases) and acute-on-chronic (1 case) PVMVT underwent transvenous thrombolysis. Read More

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http://dx.doi.org/10.5114/pjr.2018.81380DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6386773PMC
December 2018
1 Read

Comparison of TIPS alone and combined with partial splenic embolization (PSE) for the management of variceal bleeding.

Eur Radiol 2019 Feb 22. Epub 2019 Feb 22.

Gastroenterology Department II or Hepatology Center, The 2nd Affiliated Hospital of Kunming Medical University, Kunming City, 650101, Yunnan Province, China.

Objectives: Transjugular intrahepatic portosystemic shunt (TIPS) and partial splenic embolization (PSE) were two interventional radiological treatments for the complications of cirrhosis. This study aimed to investigate the effects of concomitant PSE on the long-term shunt patency and overall survival of TIPS-treated patients.

Methods: Forty-eight patients with TIPS insertion were enrolled and studied retrospectively. Read More

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http://dx.doi.org/10.1007/s00330-019-06046-6DOI Listing
February 2019

Emergency Transjugular Intrahepatic Portosystemic Shunt: an Effective and Safe Treatment for Uncontrolled Variceal Bleeding.

J Gastrointest Surg 2019 Feb 21. Epub 2019 Feb 21.

Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, No.37 Guoxue Alley, Wuhou District, Chengdu, 610041, Sichuan Province, China.

Background: Uncontrolled variceal bleeding (VB) remains a great challenge for clinical treatment. Emergency transjugular intrahepatic portosystemic shunt (TIPS) is a salvage procedure, but unsatisfactory clinical outcomes and a high incidence of complications have been reported. This study aimed to investigate the effect and safety of emergency TIPS performed in our institution during recent years. Read More

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http://dx.doi.org/10.1007/s11605-019-04146-8DOI Listing
February 2019
2.798 Impact Factor

Adjuvant Transjugular Variceal Occlusion at Creation of a Transjugular Intrahepatic Portosystemic Shunt (TIPS): Efficacy and Risks of Bucrylate Embolization.

Cardiovasc Intervent Radiol 2019 Feb 20. Epub 2019 Feb 20.

Department of Gastroenterology, University Hospital of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.

Adjuvant embolization of varices may reduce rebleeding in patients with a transjugular intrahepatic portosystemic shunt (TIPS). The aim of this study was to investigate the efficacy and the risks of adjuvant variceal embolization at TIPS implantation using bucrylate.

Patients And Methods: The retrospective study evaluated 104 of 237 cirrhotic patients with TIPS for variceal bleeding who received adjuvant bucrylate embolization. Read More

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http://dx.doi.org/10.1007/s00270-019-02176-yDOI Listing
February 2019
1 Read

Diastolic dysfunction on echocardiography does not predict survival after transjugular intrahepatic portosystemic stent-shunt in patients with cirrhosis.

Aliment Pharmacol Ther 2019 Mar 17;49(6):797-806. Epub 2019 Feb 17.

Liver Unit, Queen Elizabeth University Hospital, Birmingham, UK.

Background: Cardiac dysfunction is frequently observed in patients with cirrhosis. There remains a paucity of data from routine clinical practice regarding the role of echocardiography in the pre-assessment of transjugular intrahepatic portosystemic stent-shunt.

Aim: Our study aimed to investigate if echocardiography parameters predict outcomes after transjugular intrahepatic portosystemic stent-shunt insertion in cirrhosis. Read More

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http://dx.doi.org/10.1111/apt.15164DOI Listing
March 2019
1 Read

Endoscopic Ultrasound-Guided Angiotherapy for Gastric Varices: A Single Center Experience.

Hepatol Commun 2019 Feb 10;3(2):207-212. Epub 2018 Dec 10.

Liver Unit Institute of Gastroenterology and Liver Diseases, Division of Internal Medicine Hebrew University-Hadassah Medical Organization Jerusalem Israel.

There are limited efficacious therapeutic options for management of gastric variceal bleeding. Treatment modalities include transjugular intrahepatic portosystemic shunt, surgical shunts, and endoscopic interventions, including the recent advancement of endoscopic ultrasound (EUS)-guided coiling. We present a case series of 10 patients with portal hypertension (7 with liver cirrhosis and 3 without cirrhosis), complicated by gastric varices (GV) with bleeding. Read More

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http://dx.doi.org/10.1002/hep4.1289DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357835PMC
February 2019
1 Read

Hepatic Encephalopathy and Sarcopenia: Two Faces of the Same Metabolic Alteration.

J Clin Exp Hepatol 2019 Jan-Feb;9(1):125-130. Epub 2018 May 5.

Department of Clinical Medicine, Gastroenterology, Sapienza University of Rome, Italy.

Sarcopenia is an important burden in liver cirrhosis representing a negative prognostic factor for mortality. Moreover, sarcopenia is an independent predictor of complications in patients with liver cirrhosis, including Hepatic Encephalopathy (HE). An association between sarcopenia and HE in liver cirrhosis has been reported in recent studies, indeed both these complications often affect patients with advanced liver cirrhosis and may exert a synergic effect in deteriorating patients' outcome. Read More

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http://dx.doi.org/10.1016/j.jceh.2018.04.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363954PMC
May 2018
1 Read

Long Term Survival of Patients Undergoing TIPS in Budd-Chiari Syndrome.

J Clin Exp Hepatol 2019 Jan-Feb;9(1):56-61. Epub 2018 Mar 1.

Consultant, Department of Vascular and Interventional Radiology, Tan Tock Seng Hospital, Singapore.

Background: There has been significant improvement in understanding the etiology and management of Budd-Chiari Syndrome (BCS). Patients with chronic or acute-on-chronic BCS need radiological interventions in the form of angioplasty, hepatic vein/inferior vena cava stenting or Transjugular Intrahepatic Portosystemic Shunt (TIPS). Data regarding the long term follow up of patients undergoing TIPS is limited. Read More

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http://dx.doi.org/10.1016/j.jceh.2018.02.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363956PMC
March 2018
6 Reads

Collagen type IV remodelling gender-specifically predicts mortality in decompensated cirrhosis.

Liver Int 2019 Feb 9. Epub 2019 Feb 9.

Department of Medicine I, University of Bonn, Bonn, Germany.

Background & Aims: Remodelling of extracellular matrix is crucial in progressive liver fibrosis. Collagen type III desposition has been shown in acute decompensation. Extratracellular matrix is compiled of deposition of various components. Read More

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http://dx.doi.org/10.1111/liv.14070DOI Listing
February 2019
3 Reads

The Effect of Puncture Sites of Portal Vein in TIPS with ePTFE-Covered Stents on Postoperative Long-Term Clinical Efficacy.

Gastroenterol Res Pract 2019 9;2019:2935498. Epub 2019 Jan 9.

Department of Interventional Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515 Guangdong, China.

Purpose: To evaluate the effect of puncture sites of the portal vein in transjugular intrahepatic portosystemic shunt (TIPS) on long-term clinical efficacy.

Methods: A retrospective review was performed, including consecutive 171 patients who underwent TIPS with ePTFE-covered stents. All patients were divided into 3 groups according to the puncture site of the portal vein: intrahepatic bifurcation of the portal vein (group A, = 88), right branch of the portal vein (group B, = 48), and left branch of the portal vein (group C, = 35). Read More

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http://dx.doi.org/10.1155/2019/2935498DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343182PMC
January 2019
1 Read

Transhepatic Revision of Occluded Transjugular Intrahepatic Portosystemic Shunt Complicated by Endotipsitis.

Semin Intervent Radiol 2018 Dec 5;35(5):492-496. Epub 2019 Feb 5.

Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California.

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http://dx.doi.org/10.1055/s-0038-1676092DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363548PMC
December 2018
1 Read

The role of transjugular intrahepatic portosystemic shunt in the management of portal vein thrombosis.

Eur J Gastroenterol Hepatol 2019 03;31(3):403-404

Division of Digestive Diseases at Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel Hospital, New York City, New York, USA.

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http://dx.doi.org/10.1097/MEG.0000000000001318DOI Listing
March 2019
2 Reads

Liver and Spleen Stiffness Measurements for Assessment of Portal Hypertension Severity in Patients with Budd Chiari Syndrome.

Can J Gastroenterol Hepatol 2019 2;2019:1673197. Epub 2019 Jan 2.

Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Italy.

Aims: Budd-Chiari Syndrome (BCS) is a rare vascular disease of the liver caused by the obstruction of the hepatic venous outflow located from the small hepatic venules up to the entrance of the inferior vena cava (IVC) into the right atrium. Current prognostic indexes are suboptimal for an individual prognostic assessment and subsequent management of patients with BCS. Liver (LSM) and spleen (SSM) stiffness measurements are widely validated prognostic tools in hepatology, but the evidence in patients with BCS is limited. Read More

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http://dx.doi.org/10.1155/2019/1673197DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334356PMC
January 2019
2 Reads

Balloon Retrograde Transvenous Obliteration Versus Endoscopic Cyanoacrylate in Bleeding Gastric Varices: Comparison of Rebleeding and Mortality with Extended Follow-up.

J Vasc Interv Radiol 2019 Feb;30(2):187-194

Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Virginia Health System, 1215 Lee Street, Charlottesville, VA 22903. Electronic address:

Purpose: To assess short- and long-term mortality and rebleeding with endoscopic cyanoacrylate (EC) versus balloon-occluded retrograde transvenous obliteration (BRTO).

Materials And Methods: A retrospective cohort comparison was conducted of 90 EC patients and 71 BRTO patients from 1997 through 2015 with portal hypertension who presented due to endoscopically confirmed bleeding cardiofundal gastric varices. Patients underwent either endoscopic intra-varix injection of 4-carbon-n-butyl-2-cyanoacrylate or sclerosis with sodium tetradecyl sulfate with balloon occlusion for primary variceal treatment. Read More

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http://dx.doi.org/10.1016/j.jvir.2018.12.008DOI Listing
February 2019
3 Reads

Technical Feasibility and Clinical Effectiveness of Transjugular Intrahepatic Portosystemic Shunt Creation in Pediatric and Adolescent Patients.

J Vasc Interv Radiol 2019 Feb;30(2):178-186.e5

Division of Interventional Radiology, Department of Radiology, University of Washington, Seattle, Washington; Seattle Children's Hospital, Seattle, Washington.

Purpose: To examine the technical feasibility and clinical efficacy of transjugular intrahepatic portosystemic shunt (TIPS) creation in children and adolescents.

Materials And Methods: Retrospective review was performed of 59 patients (mean age 12.6 y [range, 1. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10510443183158
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http://dx.doi.org/10.1016/j.jvir.2018.10.003DOI Listing
February 2019
2 Reads
2.149 Impact Factor

Effect of Transjugular Intrahepatic Portosystemic Shunt Creation on Pulmonary Gas Exchange in Patients with Hepatopulmonary Syndrome: A Prospective Study.

J Vasc Interv Radiol 2019 Feb;30(2):170-177

Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Institute of Interventional Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address:

Purpose: To evaluate effect of transjugular intrahepatic portosystemic shunt (TIPS) creation on pulmonary gas exchange in patients with hepatopulmonary syndrome (HPS).

Materials And Methods: All patients with cirrhosis or Budd-Chiari syndrome undergoing elective TIPS creation at a single institution between June 2014 and June 2015 were eligible for inclusion. Twenty-three patients with HPS (age 55. Read More

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http://dx.doi.org/10.1016/j.jvir.2018.09.017DOI Listing
February 2019
1 Read

Psoas Muscle Density in Combination with Model for End-Stage Liver Disease Score Can Improve Survival Predictability in Transjugular Intrahepatic Portosystemic Shunts.

J Vasc Interv Radiol 2019 Feb;30(2):154-161

Department of Medicine, University of Alabama at Birmingham, Birmingham, D619 19th Street South, AL 35249; Department of Radiology, University of Alabama at Birmingham, Birmingham, D619 19th Street South, AL 35249. Electronic address:

Purpose: To examine the role of psoas muscle density (PD) measurement before transjugular intrahepatic portosystemic shunt (TIPS) creation in predicting survival when combined with Model for End-stage Liver Disease (MELD) score.

Materials And Methods: The medical records of 241 patients with cirrhosis who underwent TIPS creation between June 2005 and June 2015 were retrospectively reviewed. The patients were divided into 2 groups: those with variceal bleeding (VB; n = 113) and those with volume overload (VO; n = 128). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10510443183159
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http://dx.doi.org/10.1016/j.jvir.2018.10.006DOI Listing
February 2019
6 Reads

Ultrasonographic guidance for portal vein access during transjugular intrahepatic portosystemic shunt (TIPS) placement.

Diagn Interv Imaging 2019 Jan 30. Epub 2019 Jan 30.

Department of Radiology, centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.

Purpose: The purpose of our study was to retrospectively assess the safety and efficacy of percutaneous real-time ultrasound guidance for portal vein puncture during transjugular intrahepatic portosystemic shunt (TIPS) placement.

Materials And Methods: Between January 2011 and November 2018, procedure details and outcome were retrospectively analyzed for 224 patients who underwent TIPS placement using real-time ultrasound guidance for portal vein puncture. There were 175 men and 49 women with a mean age of 52. Read More

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http://dx.doi.org/10.1016/j.diii.2019.01.004DOI Listing
January 2019
1 Read

L-Ornithine L-Aspartate (LOLA) for Hepatic Encephalopathy in Cirrhosis: Results of Randomized Controlled Trials and Meta-Analyses.

Drugs 2019 Feb;79(Suppl 1):31-37

Liver Intensive Therapy Unit, Institute of Liver Sciences, School of Immunology and Microbial Sciences, Kings College London, London, UK.

This manuscript represents an appraisal of the evidence in support of L-ornithine-L-aspartate (LOLA) for the management and treatment of hepatic encephalopathy (HE) in cirrhosis. Meta-analyses of randomized controlled trials (RCTs) conducted over the last two decades generally reveal evidence of benefit of LOLA in a range of clinical presentations. This included improvement of mental state grade in overt HE (OHE) assessed by West Haven criteria as well as in minimal HE (MHE) assessed by psychometric testing where the oral formulation of LOLA was determined to be particularly effective. Read More

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http://dx.doi.org/10.1007/s40265-018-1024-1DOI Listing
February 2019
1 Read

Correlation analysis of collagen proportionate area in Budd-Chiari syndrome: A preliminary clinicopathological study.

World J Clin Cases 2019 Jan;7(2):130-136

Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang 110016, Liaoning Province, China.

Background: Collagen proportionate area (CPA) is an important index for assessing the severity of liver fibrosis. Budd-Chiari syndrome can frequently progress to liver fibrosis and cirrhosis. CPA might play an important role in the pathological progress of Budd-Chiari syndrome. Read More

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http://dx.doi.org/10.12998/wjcc.v7.i2.130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354089PMC
January 2019
3 Reads

Temporal trends of cirrhosis associated conditions.

World J Hepatol 2019 Jan;11(1):74-85

Department of Internal Medicine, the Queen's Medical Center, Honolulu, HI 968132, United States.

Background: Chronic liver disease and cirrhosis is the 12 leading cause of death in the United States. Patients with decompensated-cirrhosis, especially with hepatic encephalopathy/coma (HC), have a higher rate of early readmission and contribute to higher healthcare cost.

Aim: To evaluate the national inpatient trends of discharges, mortalities and financial impacts associated with four common conditions of cirrhosis. Read More

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https://www.wjgnet.com/1948-5182/full/v11/i1/74.htm
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http://dx.doi.org/10.4254/wjh.v11.i1.74DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354119PMC
January 2019
6 Reads

Regional gray matter abnormality in hepatic myelopathy patients after transjugular intrahepatic portosystemic shunt: a voxel-based morphometry study.

Neural Regen Res 2019 May;14(5):850-857

Department of Radiology, Xijing Hospital, Air Force Military Medical University (Fourth Military Medical University), Xi'an, Shaanxi Province, China.

Hepatic myelopathy is a complication seen in patients with chronic liver failure with physiologic or iatrogenic portosystemic shunting. The main symptom is progressive lower limb dyskinesia. The role of the brain motor control center in hepatic myelopathy is unknown. Read More

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http://dx.doi.org/10.4103/1673-5374.249233DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375042PMC
May 2019
1 Read

Expert consensus on the clinical management of pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndrome.

J Gastroenterol Hepatol 2019 Jan 22. Epub 2019 Jan 22.

Department of Gastroenterology, Zhongshan Hospital of Fudan University, Shanghai, China.

Hepatic sinusoidal obstruction syndrome (HSOS) is a hepatic vascular disease presenting with abdominal distension, pain in the hepatic region, ascites, jaundice, and hepatomegaly. In China, this disease is often associated with the oral intake of plants that contain pyrrolidine alkaloids. The existing guidelines are limited to HSOS associated with hematopoietic stem cell transplantation in Western countries. Read More

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http://doi.wiley.com/10.1111/jgh.14612
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http://dx.doi.org/10.1111/jgh.14612DOI Listing
January 2019
11 Reads

The modification of quantity and quality of muscle mass improves the cognitive impairment after TIPS.

Liver Int 2019 Jan 22. Epub 2019 Jan 22.

Department of Clinical Medicine, "Sapienza" University of Rome, Rome, Italy.

Background: Hepatic encephalopathy (HE) is the major complication of transjugular intrahepatic portosystemic shunt (TIPS). In cirrhotic patients, a correlation between sarcopenia and HE has been suggested.

Aim: To evaluate the evolution of the skeletal muscle quantity and quality at CT scan and of the patients' cognitive impairment (both overt and minimal HE) before and after TIPS. Read More

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http://dx.doi.org/10.1111/liv.14050DOI Listing
January 2019
1 Read

Use of Peritoneovenous Shunt for the Management of Refractory Ascites.

Transplant Proc 2019 Jan - Feb;51(1):41-43. Epub 2018 Jun 30.

Unit of Hepatobiliary Surgery and Liver Transplantation, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto Maimónides de Investigación Biomédica de Córdoba, University Hospital Reina Sofía, Córdoba, Spain.

Background: Guidelines for the management of refractory ascites (RA) recommend transjugular intrahepatic portosystemic shunting (TIPS), diuretics, and paracentesis as the main strategies, discouraging use of surgical peritoneovenous shunts (PVSs). However, PVSs, including both Denver (DS) or saphenoperitoneal (SPS) modalities, may still have indications. Herein we report our experience with PVSs in the context of modern surgical and anesthetic management. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00411345183088
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http://dx.doi.org/10.1016/j.transproceed.2018.04.089DOI Listing
March 2019
7 Reads

Clinical Efficacy of Transjugular Intrahepatic Portosystemic Shunt Created with Expanded Polytetrafluoroethylene-Covered Stent-Grafts: 8-mm Versus 10-mm.

Cardiovasc Intervent Radiol 2019 Jan 14. Epub 2019 Jan 14.

Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, Sichuan, People's Republic of China.

Purpose: Conflicting data exist regarding the appropriate shunt diameter for transjugular intrahepatic portosystemic shunt (TIPS) creation in cirrhotic patients. This study was designed to compare the clinical efficacy of TIPS using stent-grafts with 8- and 10-mm diameters.

Methods: In this retrospective study, cirrhotic patients who underwent TIPS technical successfully for the prevention of variceal rebleeding from December 2011 to June 2015 were included. Read More

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http://link.springer.com/10.1007/s00270-019-02162-4
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http://dx.doi.org/10.1007/s00270-019-02162-4DOI Listing
January 2019
8 Reads
1.965 Impact Factor

[Application of a multi-material artifact reduction algorithm in a wide-detector CT in the evaluation of the portal venous angiography of postoperative TIPS and embolization].

Zhonghua Yi Xue Za Zhi 2019 Jan;99(1):44-48

Department of Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

To assess the effect of monochromatic images and metal artifact reduction (MAR) on the image quality of spectral CT portal venous angiography in patients with operation of after the performing transjugular intrahepatic portosystemic stent shunt(TIPS) and embolization. From December 2017 to April 2018, the examination data of 28 patients with portal hypertension due to cirrhosis who underwent portal vein angiography 1 month after TIPS and embolization were prospectively collected. After spectral CT scanning in revolution CT, the monochromatic energy levels(60 keV, 120 keV), 60 keV + 120 keV, 120kV-like + 120 keV fused images combined with MAR algorithm were reconstructed. Read More

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http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2019.01.010DOI Listing
January 2019
2 Reads

Transjugular Intrahepatic Portosystemic Shunt (TIPS) for primary and secondary prophylaxis of variceal bleeding in hepatic schistosomiasis.

Travel Med Infect Dis 2019 Jan 11. Epub 2019 Jan 11.

I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.

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http://dx.doi.org/10.1016/j.tmaid.2019.01.006DOI Listing
January 2019
2 Reads

Proton Pump Inhibitor Use Is Associated with an Increased Frequency of New or Worsening Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt Creation.

J Vasc Interv Radiol 2019 Feb 11;30(2):163-169. Epub 2019 Jan 11.

Division of Vascular and Interventional Radiology, Department of Radiology, Duke University Medical Center, 2301 Erwin Road, Durham, North Carolina 27710. Electronic address:

Purpose: To determine whether proton pump inhibitor (PPI) use increases the rate of new or worsening hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) creation.

Materials And Methods: In this retrospective study, 284 of 365 patients who underwent TIPS creation from January 1, 2005, to December 31, 2016, were analyzed (186 male, mean age 56 y, range 19-84 y). Dates of PPI use and dates of new or worsening HE, defined as hospitalization or escalation in outpatient medical management, were extracted from medical records. Read More

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http://dx.doi.org/10.1016/j.jvir.2018.10.015DOI Listing
February 2019
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Early-Recurrent Overt Hepatic Encephalopathy Is Associated with Reduced Survival in Cirrhotic Patients after Transjugular Intrahepatic Portosystemic Shunt Creation.

J Vasc Interv Radiol 2019 Feb 9;30(2):148-153.e2. Epub 2019 Jan 9.

Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, No. 15 West Changle Road, Xi'an 710032, China. Electronic address:

Purpose: To investigate the role of early overt hepatic encephalopathy (OHE) as a clinical marker of prognosis in cirrhosis with a transjugular intrahepatic portosystemic shunt (TIPS) and to assess the relationship between recurrence of OHE and survival after TIPS.

Methods: From January 2012 to December 2013, a retrospective study of consecutive patients with cirrhosis and a TIPS was performed at a single institution. A total of 304 patients (196 males; mean age, 52 years) were enrolled during the study period. Read More

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http://dx.doi.org/10.1016/j.jvir.2018.08.023DOI Listing
February 2019
1 Read

Child-Pugh Classification: Time to Abandon?

Semin Liver Dis 2019 Feb 11;39(1):96-103. Epub 2019 Jan 11.

Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada.

The Child-Pugh classification is one of the commonest and oldest bedside tools utilized in estimating prognosis in patients with cirrhosis. However, its usage as a risk prediction tool or indeed a decision-making tool should be revisited. In this review, we discuss some inherent issues with the Child-Pugh classification and present a few contexts in which the current usage of Child-Pugh warrants reassessment, elaborating on its utility in acute variceal bleeding, specifically its role in decision-making on early transjugular intrahepatic portosystemic shunt, as well as its use in the context of hepatocellular carcinoma and drug development and dose adjustment. Read More

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http://dx.doi.org/10.1055/s-0038-1676805DOI Listing
February 2019
3 Reads

Comparison of transjugular intrahepatic portosystemic shunt for treatment of variceal bleeding in patients with cirrhosis with or without spontaneous portosystemic shunt.

Eur J Gastroenterol Hepatol 2019 Jan 9. Epub 2019 Jan 9.

Department of Gastroenterology, Nanjing Medical University Drum Tower Clinical Medical School.

Background And Aims: Transjugular intrahepatic portosystemic shunt (TIPS) is an effective intervention for portal hypertensive complications in cirrhosis. Spontaneous portosystemic shunts (SPSSs) may increase the risk of post-TIPS complications and mortality. This study was done to evaluate the safety and efficacy of TIPS for treating variceal bleeding between patients with and without SPSSs. Read More

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http://dx.doi.org/10.1097/MEG.0000000000001349DOI Listing
January 2019
7 Reads

Transjugular intrahepatic portosystemic shunt prevents rebleeding in cirrhotic patients having cavernous transformation of the portal vein without improving their survival.

J Dig Dis 2019 Feb 3;20(2):89-96. Epub 2019 Mar 3.

Department of Gastroenterology, Shandong Provincial Hospital affiliated to Shandong University, Jinan, Shandong Province, China.

Objective: To compare the efficacy of transjugular intrahepatic portosystemic shunts (TIPS) and endoscopic variceal ligations (EVL) plus propranolol in decreasing rebleeding and improving survival rates in cirrhotic patients with cavernous transformation of the portal vein (CTPV).

Methods: Cirrhotic patients with CTPV and a history of variceal bleeding who were treated for recurrent variceal bleeding between June 2010 and July 2016 were identified and classified based on the treatment they received (TIPS or EVL plus propranolol). Their characteristics and clinical data were recorded. Read More

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http://dx.doi.org/10.1111/1751-2980.12702DOI Listing
February 2019
3 Reads

No Increased Mortality After TIPS Compared with Serial Large Volume Paracenteses in Patients with Higher Model for End-Stage Liver Disease Score and Refractory Ascites.

Cardiovasc Intervent Radiol 2019 Jan 2. Epub 2019 Jan 2.

Division of Vascular and Interventional Radiology, Department of Radiology, Duke University Medical Center, Box 3808, 2301 Erwin Road, Durham, NC, 27710, USA.

Purpose: To compare survival after transjugular intrahepatic portosystemic shunt (TIPS) creation versus serial large volume paracenteses (LVP) in patients with refractory ascites and higher Model for End-Stage Liver Disease (MELD) scores.

Materials And Methods: In this retrospective study, from 1/1/2013 to 10/1/2018, 478 patients (294 male; mean age 58, range 23-89) underwent serial LVP (n = 386) or TIPS (n = 92) for ascites. Propensity-matched cohorts were constructed based on age, MELD, Charlson comorbidity index, varices, and hepatic encephalopathy. Read More

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http://dx.doi.org/10.1007/s00270-018-02155-9DOI Listing
January 2019
2 Reads

Case Series Regarding Parastomal Variceal Bleeding: Presentation and Management.

Ann Hepatol 2018 Dec;18(1):250-257

Department of Medicine, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham AL, USA.

Parastomal variceal bleeding (PVB) is a serious complication occurring in up to 27% of patients with an ostomy and concurrent cirrosis and portal hypertension. The management of PVB is difficult and there are no clear guidelines on this matter. Transjugular intrahepatic portosystemic shunt (TIPS), sclerotherapy, and /or coil embolization are all therapies that have been shown to successfully manage PVB. Read More

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http://dx.doi.org/10.5604/01.3001.0012.7934DOI Listing
December 2018
3 Reads

The effects of a transjugular intrahepatic portosystemic shunt on the diagnosis of hepatocellular cancer.

PLoS One 2018 28;13(12):e0208233. Epub 2018 Dec 28.

Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, United States of America.

Background And Aims: Transjugular intrahepatic portosystemic shunt (TIPS) may be placed to treat complications of portal hypertension by creating a conduit between the hepatic and portal vein. The diagnosis of hepatocellular carcinoma (HCC) is typically made by multiphasic imaging studies demonstrating arterial enhancement with washout on arterial, portal venous, and delayed phase imaging. The aim of our study was to determine how the presence of TIPS would affect the imaging diagnosis of HCC. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0208233PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310280PMC
December 2018
1 Read

Radiological Intervention for Shunt Related Encephalopathy.

J Clin Exp Hepatol 2018 Dec 5;8(4):452-459. Epub 2018 May 5.

Department of Clinical Medicine, Centre for the Diagnosis and Treatment of Portal Hypertension, "Sapienza" University of Rome, Rome, Italy.

Hepatic Encephalopathy (HE) is a neuropsychiatric syndrome that occurs in up to 30% of patients with cirrhosis. HE may be a consequence of pure liver failure, as in patients with fulminant hepatitis, or of the combination of liver failure and portal-systemic shunting, as in patients with liver cirrhosis. Several clinical and pathophysiologic observations suggest the importance of portal-systemic shunts in the development of HE. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S09736883183005
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http://dx.doi.org/10.1016/j.jceh.2018.04.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6286445PMC
December 2018
9 Reads

Predictors of Re-bleeding and Mortality Among Patients with Refractory Variceal Bleeding Undergoing Salvage Transjugular Intrahepatic Portosystemic Shunt (TIPS).

Dig Dis Sci 2018 Dec 17. Epub 2018 Dec 17.

UCL Institute for Liver and Digestive Health and Sheila Sherlock Liver Unit, Royal Free London NHS Foundation Trust and UCL, London, UK.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) has proven clinical efficacy as rescue therapy for cirrhotic patients with acute portal hypertensive bleeding who fail endoscopic treatment.

Aims: To investigate predictive factors of 6-week and 1-year mortality in patients undergoing salvage TIPS for refractory portal hypertensive bleeding.

Methods: A total of 144 consecutive patients were retrospectively evaluated. Read More

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http://dx.doi.org/10.1007/s10620-018-5412-xDOI Listing
December 2018
2 Reads

Morbidity and mortality after transjugular intrahepatic portosystemic shunt placement in patients with cirrhosis.

Eur J Gastroenterol Hepatol 2018 Dec 13. Epub 2018 Dec 13.

Hepatology and Liver Transplant Unit, Department of Medical Area (DAME).

Objectives: Transjugular intrahepatic portosystemic shunt (TIPS) is adopted to treat refractory complications of portal hypertension, such as variceal bleeding and ascites. This study aimed to assess predictors of hepatic encephalopathy (HE) development and cumulative transplant-free survival after TIPS placement in patients with cirrhosis complicated by refractory ascites and major gastroesophageal bleeding.

Materials And Methods: Sixty-three cirrhotic patients who underwent TIPS positioning as a secondary prophylaxis of major upper gastroesophageal bleeding (N=30) or to control refractory ascites (N=33) were enrolled. Read More

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http://dx.doi.org/10.1097/MEG.0000000000001342DOI Listing
December 2018
7 Reads