4,379 results match your criteria Transjugular Intrahepatic Portosystemic Shunt


Outcomes of transjugular intrahepatic portosystemic shunt using 12 mm diameter polytetrafluoroethylene covered stents in cirrhotic patients with portal hypertension.

Diagn Interv Radiol 2022 May;28(3):239-243

Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.

PURPOSE We aimed to evaluate the safety and efficacy of 12 mm diameter polytetrafluoroethylene (PTFE)- covered stents for the creation of transjugular intrahepatic portosystemic shunt (TIPS) in cir- rhotic patients with portal hypertension complicated by variceal bleeding and volume-overload. METHODS This retrospective study included 360 patients who had TIPS created between January 2004 and December 2017 using 12 mm diameter PTFE-covered stents. Demographic data, model for end- stage liver disease (MELD) score, etiology of cirrhosis, and Charlson comorbidity index were recorded. Read More

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The portal vein in patients with cirrhosis is not an excessively inflammatory or hypercoagulable vascular bed, a prospective cohort study.

J Thromb Haemost 2022 Jun 23. Epub 2022 Jun 23.

Surgical Research Laboratory and Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

Background: A hypercoagulable state is not associated with development of portal vein thrombosis in cirrhosis, as we previously demonstrated. However, some groups demonstrated elevated levels of inflammatory markers and activation of haemostasis in the portal vein (PV) compared to post-hepatic veins, but as the liver is involved in clearance of these markers we hypothesize that interpretation of these data is not straightforward.

Aim: To determine whether the PV has particular proinflammatory/hypercoagulable characteristics by comparing plasma sampled in the PV, hepatic vein (HV) and the systemic circulation. Read More

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Retrospective evaluation of early thrombosis in transjugular intrahepatic portosystemic polytetrafluoroethylene-coated shunts under 2-day postinterventional heparinization.

Sci Rep 2022 Jun 22;12(1):10506. Epub 2022 Jun 22.

Department of Radiology, University Hospital Regensburg, 93042, Regensburg, Germany.

The development of acute thrombosis within the TIPS tract may be prevented by prophylactic anticoagulation; however, there is no evidence of the correct anticoagulation regimen after TIPS placement. The purpose of this single-center retrospective study was to evaluate the short-term occlusion rate of transjugular intrahepatic portosystemic shunts (TIPSs) with polytetrafluorethylene (PTFE)-coated stents under consequent periprocedural full heparinization (target partial thromboplastin time [PTT]: 60-80 s). We analyzed TIPS placements that were followed up over a six-month period by Doppler ultrasound in 94 patients and compared the study group of 54 patients who received intravenous periprocedural full heparinization (target PTT: 60-80 s) without any other anticoagulation to patients with prolonged anticoagulation medication. Read More

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High resolution flow with glazing flow for optimized flow detection in transjugular intrahepatic portosystemic stent shunt (TIPS): First results.

Clin Hemorheol Microcirc 2022 Jun 14. Epub 2022 Jun 14.

Department of Radiology, Interdisciplinary Ultrasound Department, University Hospital Regensburg, Regensburg, Germany.

Background: Ultrasound follow-up of transjugular intrahepatic portosystemic shunt (TIPS) is challenging due to the bent course of the stent-graft.

Objective: Aim of this retrospective study was to assess to which extent the combination of HR flow with Glazing Flow improves hemodynamic assessment in the ultrasound follow-up of TIPS.

Methods: Comparative studies with CCDS and High Resolution (HR)-Flow with Glazing Flow were evaluated regarding image quality and artifacts on a 5-point scale (0 = cannot be assessed up to 5 = maximum image quality without artifacts). Read More

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Biliary obstruction following transjugular intrahepatic portosystemic shunt placement in a patient after liver transplantation: A case report.

World J Hepatol 2022 May;14(5):1038-1046

Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Prague 14021, Czech Republic.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is a method used to decrease portal hypertension. Biliary stricture is the rarest of the complications associated with this procedure with only 12 cases previously reported in the literature. None of these cases have documented the resolution of biliary stenosis induced by a stent graft. Read More

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Computed Tomography Images of Spontaneous Portosystemic Shunt in Liver Cirrhosis.

Can J Gastroenterol Hepatol 2022 8;2022:3231144. Epub 2022 Jun 8.

Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang 110840, China.

Spontaneous portosystemic shunt (SPSS) refers to collateral vessels that communicate between the portal vein system and systemic circulation. SPSS mainly includes esophageal varices, gastric varices, left gastric vein, recanalized paraumbilical vein, abdominal wall varices, and spontaneous splenorenal shunt. SPSS contributes to the development of hepatic encephalopathy caused by portal vein inflow bypassing and carries a higher risk of death in liver cirrhosis. Read More

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Evaluation and Treatment of GI Bleeding in a 51-year-old man.

Gastroenterology 2022 Jun 16. Epub 2022 Jun 16.

Acute Care, Trauma, and General Surgery, Kettering Health Network- Main Campus, 3535 Southern Blvd, Dayton, OH, 45429, USA. Electronic address:

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The infection risk after transjugular intrahepatic portosystemic shunt: A multiple competing risk analysis from a tertiary care center.

Dig Liver Dis 2022 Jun 10. Epub 2022 Jun 10.

Infectious Diseases I Unit, IRCCS San Matteo, Pavia, Italy and Department of Medical, Surgical, Diagnostic and Paediatric Science, University of Pavia, V.le Golgi, 19, PV, 27100, Padiglione n. 42, Pavia, Italy; Department of Medical, Surgical, Diagnostic and Paediatric Science, University of Pavia, Italy.

Background: Infections following transjugular intrahepatic portosystemic shunt (TIPS) placement have been poorly described. We aim to investigate the rate and the potential predictors of infections occurring after TIPS placement.

Methods: Single center, retrospective, observational study. Read More

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Imaging-guided interventions modulating portal venous flow: Evidence and controversies.

JHEP Rep 2022 Jul 4;4(7):100484. Epub 2022 Apr 4.

Université Paris Cité; AP-HP, Hôpital Beaujon, Service de Radiologie, Clichy; Centre de Recherche sur l'inflammation Inserm, UMR 1149, Paris, France.

Portal hypertension is defined by an increase in the portosystemic venous gradient. In most cases, increased resistance to portal blood flow is the initial cause of elevated portal pressure. More than 90% of cases of portal hypertension are estimated to be due to advanced chronic liver disease or cirrhosis. Read More

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Portal Vein Thrombosis in Cirrhosis.

J Clin Exp Hepatol 2022 May-Jun;12(3):965-979. Epub 2021 Nov 22.

Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, India.

Patients with cirrhosis of the liver are at high risk of developing portal vein thrombosis (PVT), which has a complex, multifactorial cause. The condition may present with a myriad of symptoms and can occasionally cause severe complications. Contrast-enhanced computed tomography (CT) is the gold standard for the diagnosis of PVT. Read More

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November 2021

Preoperative prediction of overt hepatic encephalopathy caused by transjugular intrahepatic portosystemic shunt.

Eur J Radiol 2022 May 28;154:110384. Epub 2022 May 28.

Zhuhai Interventional Medical Centre, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), No. 79 Kangning Road, Zhuhai, China. Electronic address:

Purpose: Preoperative prediction of overt hepatic encephalopathy (OHE) should be performed in patients with variceal bleeding treated using the transjugular intrahepatic portosystemic shunt (TIPS) procedure. A reliable prediction tool is therefore required.

Method: Patients with cirrhosis-related variceal bleeding treated using the TIPS procedure were screened at two hospitals. Read More

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The role of transjugular intrahepatic portosystemic shunt in patients with cirrhosis and ascites: Recent evolution and open questions.

Hepatology 2022 Jun 4. Epub 2022 Jun 4.

Division of Gastroenterology, Hepatic Hemodynamic Laboratory, Azienda Ospedaliero-Universitaria di Modena, and University of Modena and Reggio Emilia, Modena, Italy.

In selected patients with cirrhosis and ascites, transjugular intrahepatic portosystemic shunt (TIPS) placement improves control of ascites and may reduce mortality. In this review, we summarize the current knowledge concerning the use of TIPS for the treatment of ascites in patients with cirrhosis, from pathophysiology of ascites formation to hemodynamic consequences, patient selection, and technical issues of TIPS insertion. The combination of these factors is important to guide clinical decision-making and identify the best strategy for each individual patient. Read More

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Percutaneous CT-guided superior mesenteric vein access for portal vein recanalization-transjugular intrahepatic portosystemic shunt.

Radiol Case Rep 2022 Aug 28;17(8):2603-2606. Epub 2022 May 28.

Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical Center, 22 S. Greene Street, Suite: G2K10, Baltimore, MD 21201, USA.

Portal vein recanalization-transjugular intrahepatic portosystemic shunt (PVR-TIPS) is a valuable technique in the treatment cirrhosis and portal vein (PV) thrombosis. Only a few studies have reported cases of utilizing the transmesenteric approach in the procedure's initial portal access. Here, we report the successful utilization of a CT-guided percutaneous puncture of the superior mesenteric vein (SMV) for PVR-TIPS in a patient with splenic vein thrombosis. Read More

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Correlation of pressure gradient in three hepatic veins with portal pressure gradient.

World J Clin Cases 2022 May;10(14):4460-4469

Department of Oncology, The 9 Clinical Medical College & Beijing Shijitan Hospital, Peking University, Beijing 100038, China.

Background: The liver is one of the most important organs in the human body, with functions such as detoxification, digestion, and blood coagulation. In terms of vascular anatomy, the liver is divided into the left and the right liver by the main portal vein, and there are three hepatic efferent veins (right, middle, and left) and two portal branches. Patients with impaired liver function have increased intrahepatic vascular resistance and splanchnic vasodilation, which may lead to an increase in the portal pressure gradient (PPG) and cause portal hypertension (PHT). Read More

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Late polymicrobial transjugular intrahepatic portosystemic shunt infection in a liver transplant patient: A case report.

World J Hepatol 2022 Apr;14(4):846-853

Department of Medicine, Division of Gastroenterology and Hepatology, University of Virginia Medical Center, Charlottesville, VA 22903, United States.

Background: Infection of a transjugular intrahepatic portosystemic shunt (TIPS) stent is a rare and serious complication that most commonly occurs during TIPS creation and revision. Patients typically present with recurrent bacteremia due to shunt occlusion or vegetation. To date there are approximately 58 cases reported. Read More

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[Current Interventional Management of Acute Upper Gastrointestinal Bleeding].

Authors:
Li Yang

Sichuan Da Xue Xue Bao Yi Xue Ban 2022 May;53(3):361-366

Department of Gastroenterology and Sichuan University-University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer, West China Hospital, Sichuan University, Chengdu 610041, China.

Upper gastrointestinal bleeding (UGIB), a common medical emergency, causes significant morbidity and mortality. Endoscopic evaluation and treatment remain the standard care in patients who can be hemodynamically stabilized. However, severe bleeding despite conservative medication treatment or medication combined with endoscopic intervention occurs in 5%-10% of patients, requiring interventional or surgical treatment. Read More

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Emergent Transjugular Intrahepatic Portosystemic Shunt Creation for Acute Gastric Variceal Bleeding in Patients with Hepatocellular Carcinoma.

J Vasc Interv Radiol 2022 Jun;33(6):702-706

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, People's Republic of China. Electronic address:

A total of 42 cirrhotic patients (mean age, 51.7 years ± 10.8; 38 men) with hepatocellular carcinoma who underwent emergent transjugular intrahepatic portosystemic shunt (TIPS) creation for controlling acute gastric variceal bleeding (GVB) were included in this multicenter retrospective study. Read More

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FIB-4 and APRI as Predictive Factors for Short- and Long-Term Survival in Patients with Transjugular Intrahepatic Portosystemic Stent Shunts.

Biomedicines 2022 Apr 28;10(5). Epub 2022 Apr 28.

Department of Gastroenterology and Hepatology, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, Germany.

(1) Background: Transjugular intrahepatic portosystemic shunt (TIPS) is a standard therapy for portal hypertension. We aimed to explore the association of established baseline scores with TIPS outcomes. (2) Methods: In total, 136 liver cirrhosis patients underwent TIPS insertion, mainly to treat refractory ascites (86%), between January 2016 and December 2019. Read More

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Covered TIPS Procedure-Related Major Complications: Incidence, Management and Outcome From a Single Center.

Front Med (Lausanne) 2022 4;9:834106. Epub 2022 May 4.

Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.

Background And Objective: Transjugular intrahepatic portosystemic shunt (TIPS) is a well-established procedure for treating complications of portal hypertension. Due to the complexity of anatomy and difficulty of the puncture technique, the procedure itself might brought potential complications, such as puncture failure, bleeding, infection, and, rarely, death. The aim of this study is to explore the incidence, management, and outcome of TIPS procedure-related major complications using covered stents. Read More

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A Case of Budd-Chiari Syndrome Associated With Antiphospholipid Syndrome Treated Successfully by Transjugular Intrahepatic Portosystemic Shunt.

Clin Med Insights Case Rep 2022 18;15:11795476221100595. Epub 2022 May 18.

Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Budd Chiari syndrome (BCS) is defined as obstruction of hepatic venous outflow that can be located anywhere from small hepatic venules up to the entrance of inferior vena cava (IVC) into right atrium. Etiologies of BCS include myeloproliferative disorders, congenital, and acquired hypercoagulable states. Anticoagulation is the mainstay of treatment for all cases of BCS with a demonstrable hypercoagulable state. Read More

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Inclusion of sarcopenia improves the prognostic value of MELD score in patients after transjugular intrahepatic portosystemic shunt.

Eur J Gastroenterol Hepatol 2022 May 23. Epub 2022 May 23.

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.

Objective: To explore the predictive value of model for end-stage liver disease (MELD)-Sarcopenia score for survival of cirrhotic patients after transjugular intrahepatic portosystemic shunt (TIPS) placement.

Methods: 289 patients who underwent TIPS between February 2016 and December 2020 were included, they were divided into the sarcopenia group (n = 138) and non-sarcopenia group (n = 151) according to whether they were complicated with sarcopenia. Kaplan-Meier curve was used to analyze and compare the prognosis of the above two groups and multivariate Cox regression analysis was used to identify the independent prognostic factors. Read More

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Transjugular intrahepatic portosystemic shunt for portal hypertension: 30 years experience from China.

Liver Int 2022 May 20. Epub 2022 May 20.

Department of Liver Diseases and Interventional Radiology, Digestive Diseases Hospital, Xi'an International Medical Center Hospital, Northwest University, China.

Liver diseases are a major cause of illness and death worldwide. In China, liver diseases, primarily viral hepatitis, affect approximately 300 million people, thus having a major impact on the global burden of liver diseases. Portal hypertension is the most severe complication of chronic liver diseases, including ascites, hepatic encephalopathy and bleeding from gastroesophageal varices. Read More

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Transjugular intrahepatic portosystemic shunt with or without gastro-oesophageal variceal embolisation for the prevention of variceal rebleeding: a randomised controlled trial.

Lancet Gastroenterol Hepatol 2022 May 16. Epub 2022 May 16.

Department of Liver Diseases and Digestive Interventional Radiology, National Clinical Research Centre for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China; Department of Liver Diseases and Interventional Radiology, Digestive Diseases Hospital, Xi'an International Medical Center Hospital, Northwest University, Xi'an, China. Electronic address:

Background: The role of variceal embolisation at the time of transjugular intrahepatic portosystemic shunt (TIPS) creation for the prevention of gastro-oesophageal variceal rebleeding remains controversial. This study aimed to evaluate whether adding variceal embolisation to TIPS placement could reduce the incidence of rebleeding after TIPS in patients with cirrhosis.

Methods: We did an open-label, randomised controlled trial at one university hospital in China. Read More

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Clinical efficacy of transjugular intrahepatic portosystemic shunt created through left or right branches of the portal vein: A meta-analysis.

J Interv Med 2021 Nov 23;4(4):190-196. Epub 2021 Dec 23.

Gansu Province People's Hospital, Lanzhou, 730000, People's Republic of China.

Background And Aim: Transjugular intrahepatic portosystemic shunt (TIPS) is a technique successfully used to treat portal hypertension and its complications. However, the choice of the branch, left (L) or right (R), of the portal vein resulting in a better outcome is still under debate. Therefore, this meta-analysis aims to evaluate which branch has a better curative effect on patients treated with TIPS. Read More

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November 2021

Molecular targeted therapy causes hepatic encephalopathy in patients after Transjugular intrahepatic portosystemic shunt (TIPS): A case report and literature review.

J Interv Med 2022 Feb 26;5(1):37-39. Epub 2022 Feb 26.

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China.

We report two cases of hepatic encephalopathy caused by molecular targeted drugs after the Transjugular intrahepatic portosystemic shunt (TIPS) procedure in our center. The liver toxicities and anti-angiogenic effects induced by targeted drugs may generate an imbalance in ammonia metabolism, elevating blood ammonia levels. TIPS diverts partial blood supply from the liver, aggravates liver impairment, and shunts ammonia-rich blood from the intestine into the systemic circulation. Read More

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February 2022

Intravascular Ultrasound Guidance for Transjugular Intrahepatic Portosystemic Shunt Procedures: A Review.

AJR Am J Roentgenol 2022 May 18. Epub 2022 May 18.

Dotter Department of Interventional Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, Oregon, USA.

The most challenging and time-consuming step of transjugular intrahepatic portosystemic shunt (TIPS) procedures is obtaining appropriate portal vein access. Given the lack of real-time direct target visualization, conventional fluoroscopic guidance requires multiple passes, contributing to complications. In comparison, intravascular ultrasound (IVUS) guidance during TIPS procedures provides direct visualization of hepatic structures and real-time guidance for portal vein puncture. Read More

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State of the Art, Current Perspectives, and Controversies of Budd-Chiari Syndrome: A Review.

J Clin Med Res 2022 Apr 30;14(4):147-157. Epub 2022 Apr 30.

Department of Hepato-Biliary and Liver Transplantation Surgery, Paul Brousse University Hospital, Paris-Saclay University, 94800 Villejuif, France.

Background: Budd-Chiari syndrome (BCS) is an eponym that includes a group of conditions characterized by partial or complete hepatic venous tract outflow obstruction, and the site of obstruction may involve one or more hepatic veins, inferior vena cava, or the right atrium. The classification of BCS is based on etiology, site of obstruction, and duration. Its etiology is very heterogeneous; in particular, hepatic vein thrombosis is the most common type of obstruction and myeloproliferative disorder, the most common thrombophilic disorder, in the West. Read More

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Transjugular Intrahepatic Portosystemic Shunt for Refractory Ascites in Gaucher Disease.

Cureus 2022 Apr 8;14(4):e23941. Epub 2022 Apr 8.

Department of Gastroenterology and Hepatology, Jaslok Hospital and Research Centre, Mumbai, IND.

Gaucher disease is rare, inherited lysosomal storage disorder that leads to the excessive accumulation of certain lipids, especially within the bone marrow, liver, and spleen. We present a case of a 30-year-old man with Gaucher disease who underwent a splenectomy at the age of eight for severe cytopenia. His subsequent history was notable for recurrent avascular osteonecrosis and his liver disease progressed to portal hypertension, variceal bleeding, and refractory ascites. Read More

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Bleeding Stomal Varices and Their Interventional Management- A Series of Three Cases.

J Clin Exp Hepatol 2022 Mar-Apr;12(2):649-653. Epub 2021 Sep 10.

Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.

Although stomal and parastomal varices are uncommon causes of variceal bleeding, the mortality rate might be as high as 40%. Timely intervention is essential for the management of these ectopic bleeding varices. Due to the rarity of such varices, no standard treatment guideline is available. Read More

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September 2021

Clinical Implications, Evaluation, and Management of Hyponatremia in Cirrhosis.

J Clin Exp Hepatol 2022 Mar-Apr;12(2):575-594. Epub 2021 Sep 16.

Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Science, Bhubaneswar, Odisha, India.

Hyponatremia is the most common electrolyte abnormality in patients with decompensated cirrhosis on Liver Transplantation (LT) waiting list. Most of these patients have dilutional or hypervolemic hyponatremia secondary to splanchnic vasodilatation. Excessive secretion of the antidiuretic hormone also plays an important role. Read More

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September 2021