3,478 results match your criteria Transjugular Intrahepatic Portosystemic Shunt


Use of Peritoneovenous Shunt for the Management of Refractory Ascites.

Transplant Proc 2018 Jun 30. Epub 2018 Jun 30.

Unit of Hepatobiliary Surgery and Liver Transplantation, CIBERehd, IMIBIC, 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
June 2018
1 Read

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://dx.doi.org/10.1007/s00270-019-02162-4DOI Listing
January 2019

[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

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
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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 Jan 10. Epub 2019 Jan 10.

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
January 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 Jan 8. Epub 2019 Jan 8.

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
January 2019

Child-Pugh Classification: Time to Abandon?

Semin Liver Dis 2019 Jan 11. 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
January 2019
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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
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Transjugular intrahepatic portosystemic shunt prevents rebleeding in cirrhotic patients with cavernous transformation of the portal vein without improving survival.

J Dig Dis 2019 Jan 10. Epub 2019 Jan 10.

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

Aim: The efficacies in decreasing rebleeding and improving survival rate by transjugular intrahepatic portosystemic shunt(TIPS) and endoscopic variceal ligation(EVL) plus propranolol were compared in cirrhotic patients with cavernous transformation of the portal vein(CTPV).

Methods: Cirrhotic patients with CTPV and variceal bleeding history treated for a second prophylaxis of recurrent variceal bleeding between June 2010 and July 2016 were identified and classified based on the treatment that they received (TIPS or EVL + propranolol). Patients' demographics and clinical data were recorded. Read More

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http://dx.doi.org/10.1111/1751-2980.12702DOI Listing
January 2019
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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
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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
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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
4 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

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
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Portal Venous Interventions: How to Recognize, Avoid, or Get Out of Trouble in Transjugular Intrahepatic Portosystemic Shunt (TIPS), Balloon Occlusion Sclerosis (ie, BRTO), and Portal Vein Embolization (PVE).

Tech Vasc Interv Radiol 2018 Dec 29;21(4):267-287. Epub 2018 Jul 29.

Department of Radiological Sciences, University of California at Los Angeles, Los Angeles, CA. Electronic address:

Portal venous interventions comprise a large portion of many Interventional Radiology practices today, and remain some of the more technically challenging cases in one's repertoire of procedures. The patients upon whom these procedures are performed are often critically ill, have decompensated disease, or are burdened with comorbid conditions such that they are poor surgical candidates. This leaves them with few options outside the care of Interventional Radiology. Read More

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http://dx.doi.org/10.1053/j.tvir.2018.07.009DOI Listing
December 2018
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Transjugular intrahepatic portosystemic shunt (TIPS) placement: A comparison of outcomes between patients with hepatic hydrothorax and patients with refractory ascites.

Diagn Interv Imaging 2018 Dec 3. Epub 2018 Dec 3.

Department of Radiology, University of Minnesota, 420 Delaware St SE, MMC 292, 55455 Minneapolis, USA.

Purpose: To compare the outcomes in patients who had transjugular intrahepatic portosystemic shunts (TIPS) placed for hepatic hydrothorax with those who had it placed for refractory ascites.

Materials And Methods: One hundred and forty-seven patients who underwent TIPS placement for refractory fluid accumulation were included. There were 97 men and 50 women with a mean age of 56. Read More

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http://dx.doi.org/10.1016/j.diii.2018.10.006DOI Listing
December 2018
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[Life-threatening bleeding from ileal conduit venous varices in a patient with portal hypertension].

Urologe A 2018 Dec 11. Epub 2018 Dec 11.

Radiologische Klinik, Universitätsklinikum Bonn, Sigmund-Freud-Straße 25, 53127, Bonn, Deutschland.

Life-threatening bleeding from portosystemic varices is a feared complication of portal hypertension. Particularly, varices in atypical locations-so-called ectopic varices-pose a challenge for diagnosis and therapy. In the present article, we describe the case of a patient with liver cirrhosis and recurrent bleeding from an ileal conduit resulting from peristomal varicosis. Read More

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http://dx.doi.org/10.1007/s00120-018-0824-yDOI Listing
December 2018

Tei index is associated with survival in cirrhosis patients treated with transjugular intrahepatic portosystemic shunt.

Echocardiography 2019 01 1;36(1):61-66. Epub 2018 Dec 1.

Department of Ultrasound, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is the method of choice for the treatment of portal hypertension. The Tei index is the most sensitive indicator of myocardial function.

Design: This study enrolled 31 patients with cirrhosis who underwent TIPS and were followed up over a median period of 34 months (range 2-60 months). Read More

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http://dx.doi.org/10.1111/echo.14201DOI Listing
January 2019
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Changes in arterial oxygenation after portal decompression in Budd-Chiari syndrome patients with hepatopulmonary syndrome.

Eur Radiol 2018 Nov 30. Epub 2018 Nov 30.

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, 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.

Objectives: To evaluate the changes in arterial oxygenation after portal decompression in Budd-Chiari syndrome (BCS) patients with hepatopulmonary syndrome (HPS).

Methods: From June 2014 to June 2015, all patients with BCS who underwent balloon angioplasty or transjugular intrahepatic portosystemic shunt (TIPS) creation at our institution were eligible for inclusion in this study. Arterial blood gas analysis was performed with the patient in an upright position and breathing room air at 2-3 days and 1 and 3 months after the procedure. Read More

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http://link.springer.com/10.1007/s00330-018-5840-1
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http://dx.doi.org/10.1007/s00330-018-5840-1DOI Listing
November 2018
10 Reads

Gastrointestinal Bleeding Secondary to Portal Hypertensive Duodenopathy in a Patient with Decompensated Liver Cirrhosis.

Case Rep Gastrointest Med 2018 18;2018:9430701. Epub 2018 Oct 18.

Department of Gastroenterology and Hepatology, Louisiana State University Health Sciences Center, Shreveport, LA, USA.

With alcoholic cirrhosis and nonalcoholic fatty liver disease continuously on the rise in the United States, there is also a corresponding rise in portal hypertension. Portal hypertensive duodenopathy (PHD) is a complication of portal hypertension not commonly seen in cirrhotic patients. We present a case of a 46-year-old man who presented with decompensated liver cirrhosis secondary to gastrointestinal bleed. Read More

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http://dx.doi.org/10.1155/2018/9430701DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6220751PMC
October 2018
8 Reads

Stepwise evaluation of liver sectors and liver segments by endoscopic ultrasound.

World J Gastrointest Endosc 2018 Nov;10(11):326-339

Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute, Lucknow 226014, Uttar Pradesh, India.

The liver has eight segments, which are referred to by numbers or by names. The numbering of the segments is done in a counterclockwise manner with the liver being viewed from the inferior surface, starting from Segment I (the caudate lobe). Standard anatomical description of the liver segments is available by computed tomographic scan and ultrasonography. Read More

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http://dx.doi.org/10.4253/wjge.v10.i11.326DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6247100PMC
November 2018
6 Reads

Critical Care Management of Gastrointestinal Bleeding and Ascites in Liver Failure.

Semin Respir Crit Care Med 2018 Oct 28;39(5):566-577. Epub 2018 Nov 28.

Division of Gastroenterology and Hepatology, Center for Liver Diseases and Transplantation, Weill Cornell Medical College, New York, New York.

Gastrointestinal (GI) bleeding and ascites are two significant clinical events that frequently present in critically ill patients with chronic liver failure or decompensated cirrhosis. GI bleeding in patients with cirrhosis, particularly portal hypertensive-associated bleeding, carries a high short-term mortality (15-25%) and requires early initiation of a vasoactive agent and antibiotics as well as timely endoscopic management. Conservative transfusion strategies and adequate airway protection are also imperative to assist in bleeding control. Read More

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http://dx.doi.org/10.1055/s-0038-1672200DOI Listing
October 2018
8 Reads

Transjugular intrahepatic portosystemic shunt as a bridge to liver transplant: Current state and future directions.

Transplant Rev (Orlando) 2018 Oct 31. Epub 2018 Oct 31.

Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, United States; Division of Medical Oncology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States; Yale Cancer Center, Yale School of Medicine, New Haven, CT, United States. Electronic address:

Liver transplantation is one of the mainstays of treatment for liver failure due to severe chronic liver disease. Bridging therapies, such as placement of a transjugular intrahepatic portosystemic shunt (TIPS), are frequently employed to control complications of portal hypertension such as ascites, hydrothorax, and variceal bleeding, and thereby reduce morbidity in patients awaiting transplant. There is no significant difference seen in either graft survival or patient survival between those receiving TIPS pre-transplant and those who do not, although those receiving TIPS placement on average have a longer waiting time on the transplant waitlist. Read More

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http://dx.doi.org/10.1016/j.trre.2018.10.004DOI Listing
October 2018
2 Reads

The Choice of Interventional Treatment of Gastric Variceal Hemorrhage: What Is Better?

Authors:
Moon Young Kim

Gut Liver 2018 11;12(6):611-612

Department of Internal Medicine and Cell Therapy and Tissue Engineering Center, Yonsei University Wonju College of Medicine, Wonju, Korea.

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http://www.gutnliver.org/journal/view.html?doi=10.5009/gnl18
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http://dx.doi.org/10.5009/gnl18464DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6254619PMC
November 2018
4 Reads

Systematic review with meta-analysis: portal vein recanalisation and transjugular intrahepatic portosystemic shunt for portal vein thrombosis.

Aliment Pharmacol Ther 2019 Jan 18;49(1):20-30. Epub 2018 Nov 18.

Swiss Liver Center, Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital, Department of Biomedical Research, University of Bern, Berne, Switzerland.

Background: Transjugular intrahepatic portosystemic shunt has been increasingly used in patients with portal vein thrombosis to obtain patency, but evidenced-based decisions are challenging.

Aim: To evaluate published data on efficacy and safety of endovascular therapy in portal vein thrombosis.

Methods: Systematic search of PubMed, ISI, Scopus, and Embase for studies (in English, until October 2017) reporting feasibility, safety, 12-month portal vein recanalisation, transjugular intrahepatic portosystemic shunt patency, and survival in patients with benign portal vein thrombosis undergoing endovascular treatment. Read More

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http://doi.wiley.com/10.1111/apt.15044
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http://dx.doi.org/10.1111/apt.15044DOI Listing
January 2019
7 Reads

Percutaneous extrahepatic splenomeso-caval shunt creation in a patient with portal vein thrombosis after Whipple procedure.

Clin Imaging 2019 Jan - Feb;53:221-224. Epub 2018 Oct 23.

Division of Vascular and Interventional Radiology, Department of Radiology, Mayo Clinic, Rochester, MN, USA.

A 72-year-old male presented with refractory ascites secondary to portal vein occlusion with cavernomatous transformation following pancreaticoduodenectomy (Whipple procedure). Due to the unfavorable anatomy, transjugular intrahepatic portosystemic shunt was not an option. However, given patency of the spleno-mesenteric confluence and absence of the pancreatic head after the Whipple procedure, a splenomeso-caval shunt was successfully created using a transjugular-transsplenic rendezvous technique. Read More

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http://dx.doi.org/10.1016/j.clinimag.2018.10.019DOI Listing
October 2018
1 Read

Timing of Transjugular Intrahepatic Portosystemic Stent-shunt in Budd-Chiari Syndrome: A UK Hepatologist's Perspective.

J Transl Int Med 2018 Sep 9;6(3):97-104. Epub 2018 Oct 9.

Liver Unit, Queen Elizabeth Hospital, Birmingham, UK.

Budd-Chiari syndrome (BCS) is a rare but fatal disease caused by the obstruction in hepatic venous outflow tract (usually by thrombosis) and is further classified into two subtypes depending on the level of obstruction. Patients with BCS often have a combination of prothrombotic risk factors. Clinical presentation is diverse. Read More

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http://dx.doi.org/10.2478/jtim-2018-0022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231303PMC
September 2018
5 Reads

Does colectomy affect the progression of primary sclerosing cholangitis? A systematic review and meta-analysis.

Gastroenterol Hepatol Bed Bench 2018 ;11(4):277-283

Department of Gastroenterology, Bedford Hospital South Wing, Kempston Road, Bedford MK42 9DJ, United Kingdom.

Aim: The aim of this systematic review was to determine if the human colon, through the lower gut-liver axis, drives PSC activity by assessing the progression of the disease in patients with and without colectomy for colonic disease.

Background: The gut-liver axis is involved in the pathogenesis of liver disease. Abnormal immune-mediated responses to intestinal microbiome are implicated in primary sclerosing cholangitis (PSC) however the mechanisms remain poorly understood. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204254PMC
January 2018
1 Read

Early TIPS failure in association with left mesenterico-gonadal spontaneous portosystemic venous shunt; a case report.

Clin Imaging 2019 Jan - Feb;53:200-203. Epub 2018 Oct 27.

Department of Radiology, University of Kentucky Chandler Medical Center, Lexington, KY, United States of America. Electronic address:

Transjugular intrahepatic portosystemic shunt (TIPS) periprocedural thrombosis rates have fallen significantly since the introduction of polytetrafluoroethylene-covered stent grafts. We present a case of a cirrhotic patient with portal hypertension presenting with early TIPS thrombosis in association with an underlying competing spontaneous left mesenterico-gonadal venous shunt, an uncommon variant of spontaneous portal systemic shunt (SPSS). The patient presented with bleeding distal duodenal varices refractory to endovascular therapy, and although a successful TIPS procedure was performed for this indication, early thrombosis was determined by follow-up abdominopelvic computed tomographic angiography (CTA) scan. Read More

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https://www.researchgate.net/publication/328557068_Early_TIP
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https://www.clinicalimaging.org/article/S0899-7071(18)30293-
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https://linkinghub.elsevier.com/retrieve/pii/S08997071183029
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http://dx.doi.org/10.1016/j.clinimag.2018.10.023DOI Listing
October 2018
8 Reads

Identifying optimal candidates for early TIPS among patients with cirrhosis and acute variceal bleeding: a multicentre observational study.

Gut 2018 Nov 10. Epub 2018 Nov 10.

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.

Objectives: Early placement of transjugular intrahepatic portosystemic shunt (TIPS) has been shown to improve survival in high-risk patients (Child-Pugh B plus active bleeding at endoscopy or Child-Pugh C 10-13) with cirrhosis and acute variceal bleeding (AVB). However, early TIPS criteria may overestimate the mortality risk in a significant proportion of patients, and the survival benefit conferred by early TIPS in such patients has been questioned. Alternative criteria have been proposed to refine the criteria used to identify candidates for early TIPS. Read More

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http://gut.bmj.com/lookup/doi/10.1136/gutjnl-2018-317057
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http://dx.doi.org/10.1136/gutjnl-2018-317057DOI Listing
November 2018
8 Reads

Excellent long-term outcomes of endovascular treatment in budd-chiari syndrome with hepatic veins involvement: A STROBE-compliant article.

Medicine (Baltimore) 2018 Oct;97(43):e12944

Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University.

This study aimed to evaluate the long-term efficacy and safety of percutaneous transhepatic balloon angioplasty (PTBA) and transjugular intrahepatic portosystemic stent-shunt (TIPSS) in the treatment of Budd-Chiari syndrome (BCS) with hepatic veins involvement. Between June 2008 and August 2016, a total of 60 BCS patients with hepatic vein involvement in our department were enrolled in this study. Thirty-three cases underwent hepatic vein balloon angioplasty in PTBA Group and 27 cases underwent TIPSS. Read More

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http://dx.doi.org/10.1097/MD.0000000000012944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221688PMC
October 2018
8 Reads

The Feasibility of Using Volumetric Phase-Contrast MR Imaging (4D Flow) to Assess for Transjugular Intrahepatic Portosystemic Shunt Dysfunction.

J Vasc Interv Radiol 2018 Dec 3;29(12):1717-1724. Epub 2018 Nov 3.

Department of Radiology, Washington University School of Medicine, St. Louis, Missouri.

Purpose: To demonstrate the feasibility of detecting patency, stenosis, or occlusion of transjugular intrahepatic portosystemic shunt (TIPS) with four-dimensional (4D) flow MR imaging.

Materials And Methods: Sequential adult patients with TIPS were eligible for enrollment. Volumetric phase-contrast sequence was used to image TIPS. Read More

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http://dx.doi.org/10.1016/j.jvir.2018.07.022DOI Listing
December 2018
1 Read

Cost-Effectiveness of Transjugular Intrahepatic Portosystemic Shunt versus Large-Volume Paracentesis in Refractory Ascites: Results of a Markov Model Incorporating Individual Patient-Level Meta-Analysis and Nationally Representative Cost Data.

J Vasc Interv Radiol 2018 Dec 2;29(12):1705-1712. Epub 2018 Nov 2.

Department of Interventional Radiology, University of Washington Medical Center, 1959 NE Pacific Street, Seattle, WA 98195.

Purpose: To compare relative cost-effectiveness of serial large-volume paracentesis (LVP) and transjugular intrahepatic portosystemic shunt (TIPS) creation for treatment of refractory ascites.

Materials And Methods: A decisional Markov model was developed to estimate payer cost and quality-adjusted life-ears (QALYs) associated with LVP and TIPS treatment strategies for cirrhotic patients with refractory ascites. Survival estimates were derived from an individual patient-level meta-analysis of prospective randomized clinical trials. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10510443183144
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http://dx.doi.org/10.1016/j.jvir.2018.08.019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334842PMC
December 2018
7 Reads

Transjugular Intrahepatic Portosystemic Shunt for the Treatment of Portal Hypertension-Induced Refractory Ascites Due to Metastatic Carcinomatous Liver Disease.

J Vasc Interv Radiol 2018 Dec 2;29(12):1713-1716. Epub 2018 Nov 2.

Department of Radiology, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium. Electronic address:

Three patients with a medical history of breast carcinoma and metastatic carcinomatous liver disease associated with severe portal hypertension and refractory ascites are presented. Transjugular intrahepatic portosystemic shunt creation was considered as a palliative treatment option and a valuable alternative to regular paracenteses in these patients. In 2 of the 3 patients, the refractory ascites was controlled for several months without need for paracentesis, and subsequently transjugular intrahepatic portosystemic shunt may provide valuable palliation and ascites control in patients with refractory ascites due to breast cancer-induced pseudocirrhosis. Read More

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http://dx.doi.org/10.1016/j.jvir.2018.08.007DOI Listing
December 2018
3 Reads

Treatment with proton pump inhibitors increases the risk for development of hepatic encephalopathy after implantation of transjugular intrahepatic portosystemic shunt (TIPS).

United European Gastroenterol J 2018 Nov 15;6(9):1380-1390. Epub 2018 Aug 15.

Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Background And Objective: Treatment with proton pump inhibitors (PPIs) has been associated with development of hepatic encephalopathy (HE). As development of HE is a major complication after implantation of a transjugular intrahepatic portosystemic shunt (TIPS), we hypothesized that PPI treatment may be associated with a higher risk of post-TIPS HE.

Methods: We analyzed data of 397 patients with liver cirrhosis who received de novo TIPS implantation at the University Medical Center Freiburg, Germany. Read More

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http://dx.doi.org/10.1177/2050640618795928DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206537PMC
November 2018
8 Reads

Long-Term Outcome of Veno-Occlusive Disease After Liver Transplant: A Retrospective Single-Center Experience.

Exp Clin Transplant 2018 Oct 24. Epub 2018 Oct 24.

From the Department of General Surgery, Liver Transplant Center, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.

Objectives: Veno-occlusive disease after liver transplant has been sporadically reported, and significant uncertainty exists concerning the best treatment and the long-term outcomes. Here, we reviewed our experience to evaluate clinical presentation, treatment, and the long-term outcomes of these patients.

Materials And Methods: Between 2000 and 2015, 2165 patients underwent liver transplant at our center. Read More

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http://ectrx.org/forms/ectrxcontentshow.php?doi_id=10.6002/e
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http://dx.doi.org/10.6002/ect.2017.0315DOI Listing
October 2018
4 Reads

Surgical portosystemic shunts versus transjugular intrahepatic portosystemic shunt for variceal haemorrhage in people with cirrhosis.

Cochrane Database Syst Rev 2018 10 31;10:CD001023. Epub 2018 Oct 31.

Department of Surgery, University of Pretoria, Pretoria, South Africa, 0001.

Background: Variceal haemorrhage that is refractory or recurs after pharmacologic and endoscopic therapy requires a portal decompression shunt (either surgical shunts or radiologic shunt, transjugular intrahepatic portosystemic shunt (TIPS)). TIPS has become the shunt of choice; however, is it the preferred option? This review assesses evidence for the comparisons of surgical portosystemic shunts versus TIPS for variceal haemorrhage in people with cirrhotic portal hypertension.

Objectives: To assess the benefits and harms of surgical portosystemic shunts versus transjugular intrahepatic portosystemic shunt (TIPS) for treatment of refractory or recurrent variceal haemorrhage in people with cirrhotic portal hypertension. Read More

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http://doi.wiley.com/10.1002/14651858.CD001023.pub3
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http://dx.doi.org/10.1002/14651858.CD001023.pub3DOI Listing
October 2018
15 Reads

Risk factors for hepatic veno-occlusive disease caused by Gynura segetum: a retrospective study.

BMC Gastroenterol 2018 Oct 26;18(1):156. Epub 2018 Oct 26.

Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Donglu, Zhengzhou, 450052, Henan, China.

Background: Hepatic veno-occlusive disease (HVOD) caused by Gynura segetum has been increasingly reported in China in recent years. The aim of this retrospective study was to identify independent prognostic markers for survival in patients with Gynura segetum-induced HVOD and to evaluate the effect of anticoagulants and transjugular intrahepatic portosystemic shunt (TIPS) on survival rate.

Methods: Clinical data including symptoms, signs, imaging characteristics, laboratory test results, results of liver tissue biopsies, type of treatment during follow-up and clinical outcomes were collected. Read More

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https://bmcgastroenterol.biomedcentral.com/articles/10.1186/
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http://dx.doi.org/10.1186/s12876-018-0879-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204041PMC
October 2018
10 Reads
2.370 Impact Factor

Precision Onion Skinning Technique for Transjugular Intrahepatic Portosystemic Shunt Revision.

Cureus 2018 Aug 22;10(8):e3180. Epub 2018 Aug 22.

Interventional Radiology, University of Florida Health, Jacksonville, USA.

A transjugular intrahepatic portosystemic shunt is the standard of care for complications of portal hypertension, such as variceal bleeding, refractory ascites, and hepatic hydrothorax. Hepatic encephalopathy, hepatic insufficiency, and right heart failure are the major complications after shunt creation. If medical management is unsuccessful, the interventionalist is consulted to close/revise the shunt. Read More

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https://www.cureus.com/articles/13698-precision-onion-skinni
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http://dx.doi.org/10.7759/cureus.3180DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6199139PMC
August 2018
7 Reads

Pre-emptive TIPS for acute variceal bleed: Choose your patient well!

Authors:
Sandeep Satsangi

Hepatology 2018 Oct 24. Epub 2018 Oct 24.

B.G.S Gleneagles Global Hospital, Global Integrated Liver Care, 67, Uttarahalli Road, Fort Kengeri, Bangalore, Karnataka, India.

I read with great interest the manuscript published by Procopet B et al. The authors have eloquently demonstrated the survival benefit of pre-emptive transjugular intrahepatic portosystemic shunt (p-TIPS) placement in patients with Child C cirrhosis presenting with acute variceal bleed (AVB). This article is protected by copyright. Read More

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http://doi.wiley.com/10.1002/hep.30328
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http://dx.doi.org/10.1002/hep.30328DOI Listing
October 2018
25 Reads
11.055 Impact Factor

Portal vein thrombosis in cirrhotic patients - it is always the small pieces that make the big picture.

World J Gastroenterol 2018 Oct;24(39):4419-4427

Department of Gastroenterology, "Grigore T Popa" University of Medicine and Pharmacy, Iași 700115, Romania.

Portal vein thrombosis (PVT) is a frequent and serious complication in patients with liver cirrhosis (LC). Recently, a new classification of PVT was proposed, although the functional component was not completed included. The status of liver disease (compensated/decompensated) should be added to this classification. Read More

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http://www.wjgnet.com/1007-9327/full/v24/i39/4419.htm
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http://dx.doi.org/10.3748/wjg.v24.i39.4419DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196341PMC
October 2018
5 Reads

Renal Failure in Patients with Liver Cirrhosis: Novel Classifications, Biomarkers, Treatment.

Visc Med 2018 Aug 14;34(4):246-252. Epub 2018 Aug 14.

Department of Internal Medicine II, University of Saarland, Homburg/Saar, Germany.

Renal failure is a severe complication in patients with liver cirrhosis. It is associated with increased mortality and morbidity. Diagnosis is a challenge because it is mainly based on serum creatinine, which does not seem to be an ideal measure of renal function in cirrhosis. Read More

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https://www.karger.com/Article/FullText/492587
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http://dx.doi.org/10.1159/000492587DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189538PMC
August 2018
13 Reads

[Follow-up study of 116 cases of transjugular intrahepatic portosystemic shunt in the treatment of cirrhotic portal hypertension].

Zhonghua Gan Zang Bing Za Zhi 2018 Aug;26(8):596-600

Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430000, China.

To investigate the incidence rate of transjugular intrahepatic portosystemic shunt (TIPS) complications in the treatment of cirrhotic portal hypertension, and analyze the cause of complication to management methods. Data of 116 patients obtained from Zhongnan Hospital of Wuhan University were retrospectively analyzed. Portal venous pressure, routine blood test, coagulation test, liver and kidney function test, ammonia blood test, imaging and endoscopy reports were collected before and after procedure. Read More

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http://dx.doi.org/10.3760/cma.j.issn.1007-3418.2018.08.007DOI Listing
August 2018
1 Read

Benefits of Early Treatment for Patients with Hepatic Myelopathy Secondary to TIPS: A Retrospective Study in Northern China.

Sci Rep 2018 Oct 12;8(1):15184. Epub 2018 Oct 12.

Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

Transjugular intrahepatic portosystemic shunt (TIPS) is an effective therapy for reducing portal pressure. Hepatic myelopathy (HM), a rare complication of chronic liver diseases, remains obscure in terms of treatment and prognosis. We aimed to determine an optimal treat strategy for patients with HM after TIPS. Read More

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http://www.nature.com/articles/s41598-018-33216-1
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http://dx.doi.org/10.1038/s41598-018-33216-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6185955PMC
October 2018
2 Reads

Race and Gradient Difference Are Associated with Increased Risk of Hepatic Encephalopathy Hospital Admission After Transjugular Intrahepatic Portosystemic Shunt Placement.

J Clin Exp Hepatol 2018 Sep 30;8(3):256-261. Epub 2017 Dec 30.

Transplant and Advanced Liver Disease Center, Banner University Medical Center, Phoenix, AZ, USA.

Background/aims: Hepatic encephalopathy (HE) is a well-recognized complication of transjugular intrahepatic portosystemic shunt (TIPS) placement. The aim of this investigation was to evaluate incidence and predictors of post-TIPS HE necessitating hospital admission in a non-clinical trial setting.

Methods: We performed a retrospective cohort study identifying 273 consecutive patients undergoing TIPS from 2010 to 2015 for any indication; 210 met inclusion/exclusion criteria. Read More

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http://dx.doi.org/10.1016/j.jceh.2017.12.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175770PMC
September 2018
2 Reads

Technical success and outcomes in pediatric patients undergoing transjugular intrahepatic portosystemic shunt placement: a 20-year experience.

Pediatr Radiol 2019 Jan 6;49(1):128-135. Epub 2018 Oct 6.

Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) placement has been extensively studied in adults. The experience with TIPS placement in pediatric patients, however, is limited.

Objective: The purpose of this study was to report technical success and clinical outcomes in pediatric patients undergoing TIPS placement. Read More

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http://link.springer.com/10.1007/s00247-018-4267-9
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http://dx.doi.org/10.1007/s00247-018-4267-9DOI Listing
January 2019
5 Reads

Shear wave elastography prior to transjugular intrahepatic portosystemic shunt may predict the decrease in hepatic vein pressure gradient.

Abdom Radiol (NY) 2018 Oct 4. Epub 2018 Oct 4.

Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure used to treat portal hypertension complications. Our aim was to evaluate liver and spleen stiffness measurement (LSM and SSM, respectively) changes using acoustic radiation force impulse imaging (ARFI) in comparison to Child-Pugh scores for predicting hepatic venous pressure gradient (HVPG) decreases after TIPS implantation.

Methods: This prospective study included 31 consecutive clinically significant portal hypertension patients with TIPS indication. Read More

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http://dx.doi.org/10.1007/s00261-018-1795-6DOI Listing
October 2018
2 Reads

Long-term clinical outcomes in patients with viral hepatitis related liver cirrhosis after transjugular intrahepatic portosystemic shunt treatment.

Virol J 2018 10 1;15(1):151. Epub 2018 Oct 1.

Department of Radiology, China-Japan Union Hospital of Jilin University, 126 Xintai St, Changchun, 130022, Jilin Province, China.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) procedure has played a vital role in management of portal hypertension. Thus, we aimed to investigate the natural history, long-term clinical outcome, predictors of survival in viral hepatitis related cirrhotic patients post-TIPS.

Method: A total of 704 patients with complete followed-up data were enrolled, and clinical characteristics of patients were collected and analyzed. Read More

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http://dx.doi.org/10.1186/s12985-018-1067-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6167830PMC
October 2018
6 Reads

Treatment of peristomal hemorrhage: A review of outcomes and comparison of two minimally invasive techniques.

Diagn Interv Imaging 2018 Dec 29;99(12):793-799. Epub 2018 Sep 29.

Department of Radiology, University of Minnesota, Minneapolis, MN 55455, USA.

Purpose: The purpose of this study was to review and compare outcomes between percutaneous sclerotherapy and transjugular intrahepatic portosystemic shunt (TIPS) treatments in patients with peristomal variceal bleeding.

Materials And Methods: Ten patients who underwent sclerotherapy (n = 3 patients), TIPS placement (n = 5 patients) or both (n= 2 patients) for peristomal variceal bleeding were retrospectively reviewed. There were 6 women and 4 men, with a mean age of 62. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S22115684183022
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http://dx.doi.org/10.1016/j.diii.2018.08.017DOI Listing
December 2018
2 Reads