3,748 results match your criteria Transjugular Intrahepatic Portosystemic Shunt


Managing Acute Portal Hypertensive Gastropathy Bleed During the Time of COVID-19 Pandemic: Novelty or Necessity?

Cureus 2020 May 28;12(5):e8333. Epub 2020 May 28.

Gastroenterology, Cochin Gastroenterology Group, Kochi, IND.

Acute bleeding from portal hypertensive gastropathy (PHG) is an extremely rare event in the natural history of cirrhosis. The treatment recommendations include portal pressure reduction strategies including pharmacotherapy with vasoactive agents and beta-blockers and interventional strategies such as transjugular intrahepatic portosystemic shunt placement. In this report, we present the case of a patient with cirrhosis in whom acute PHG-related bleed was managed with endoscopic band ligation, a therapeutic modality which has not been described in current literature. Read More

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http://dx.doi.org/10.7759/cureus.8333DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255538PMC

Role of Doppler Ultrasound Combined With Clinical Features in the Diagnosis of Transjugular Intrahepatic Portosystemic Shunt Dysfunction in the Era of Covered Stents.

J Ultrasound Med 2020 May 29. Epub 2020 May 29.

Department of Medical Imaging, Haifa, Israel.

Objectives: Our goal was to discuss the role of Doppler ultrasound (US), combined with clinical features, in the diagnosis of transjugular intrahepatic portosystemic shunt (TIPS) dysfunction in the era of covered stents. In light of the lack of research regarding the accuracy of Doppler US in TIPS dysfunction evaluations when using covered stents and a recent major meta-analysis, which primarily reviewed studies with bare metal stents but few with covered stents, we aimed to provide our single-center case study for further investigation.

Methods: All patients from 2010 to 2019 who underwent angiography for a covered stent preceded by a Doppler US examination in our institution were retrospectively reviewed. Read More

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http://dx.doi.org/10.1002/jum.15346DOI Listing

High-mobility group protein B1: a predictive biomarker for hepatic encephalopathy after transjugular intrahepatic portosystemic shunt.

J Hepatobiliary Pancreat Sci 2020 May 28. Epub 2020 May 28.

Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital, No.10 Tieyi Road, Yangfangdian street, Haidian District, Beijing, 100038, China.

Purpose: To investigate whether portal level of High-mobility group protein B1 (HMGB1) is associated with hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS).

Methods: We enrolled 127 consecutive patients who underwent TIPS and collected portal and peripheral blood samples in our department from December 2017 to May 2019. HMGB1 levels were determined using enzyme-linked immunosorbent assay kits. Read More

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http://dx.doi.org/10.1002/jhbp.770DOI Listing

Transjugular intrahepatic portosystemic shunt placement: portal vein puncture guided by 3D/2D image registration of contrast-enhanced multi-detector computed tomography and fluoroscopy.

Abdom Radiol (NY) 2020 May 25. Epub 2020 May 25.

Department of Diagnostic and Interventional Radiology, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany.

Background: To assess the technical feasibility, success rate, puncture complications and procedural characteristics of transjugular intrahepatic portosystemic shunt (TIPS) placement using a three-dimensional vascular map (3D-VM) overlay based on image registration of pre-procedural contrast-enhanced (CE) multi-detector computed tomography (MDCT) for portal vein puncture guidance.

Materials And Methods: Overall, 27 consecutive patients (59 ± 9 years, 18male) with portal hypertension undergoing elective TIPS procedure were included. TIPS was guided by CE-MDCT overlay after image registration based on fluoroscopic images. Read More

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http://dx.doi.org/10.1007/s00261-020-02589-1DOI Listing

Balloon-occluded retrograde transvenous obliteration (BRTO) of gastric varices using foam sclerosant and a reduced balloon inflation time: Feasibility and efficacy.

J Med Imaging Radiat Oncol 2020 May 22. Epub 2020 May 22.

Department of Radiology, Alfred Health, Melbourne, Victoria, Australia.

Introduction: Balloon-occluded retrograde transvenous obliteration (BRTO) is recommended for secondary prevention of gastric variceal bleeding in the American Association for the Study of Liver Disease (AASLD) guidelines, as an alternative to Transjugular intrahepatic portosystemic shunt (TIPS). However, there is significant heterogeneity in how BRTO is performed, including how and how long to occlude the outflow venous shunt amongst other variables such as variceal size, flow rate, agent used, and preparation technique. We propose a method using foam sclerotherapy and reducing balloon occlusion to as little as 30 min, with assessment of the efficacy of this shorter balloon inflation time. Read More

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http://dx.doi.org/10.1111/1754-9485.13049DOI Listing

Predictors of Occurrence and Risk of Hepatic Encephalopathy After TIPS Creation: A 15-Year Experience.

Cardiovasc Intervent Radiol 2020 May 20. Epub 2020 May 20.

Cleveland Clinic, Cleveland, OH, USA.

Purpose: To identify clinical variables, including use of newer Viatorr TIPS endoprosthesis with controlled expansion (VCX) that may affect the occurrence and risk of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt (TIPS) creation.

Methods: A total of 376 patients who underwent TIPS creation at our institution between 2003 and 2018 were retrospectively identified. Of these patients, 71 received a Viatorr controlled expansion endoprosthesis and 305 received a Viatorr TIPS endoprosthesis (older version without controlled expansion). Read More

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http://dx.doi.org/10.1007/s00270-020-02512-7DOI Listing

Hepatobiliary MR contrast agents are useful to diagnose hepatocellular carcinoma in patients with Budd-Chiari syndrome.

JHEP Rep 2020 Jun 9;2(3):100097. Epub 2020 Mar 9.

Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France.

Background & Aims: Hepatobiliary phase (HBP) images can discriminate between benign and malignant liver lesions, but it is unclear if this approach can be used in patients with Budd-Chiari syndrome (BCS). Thus, we aimed to assess the diagnostic utility of HBP images in patients with BCS.

Methods: This retrospective study included all patients admitted to our institution with a diagnosis of BCS and focal liver lesions on hepatobiliary contrast agent-enhanced MR imaging (HBCA-MRI) from 2000 to 2019. Read More

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http://dx.doi.org/10.1016/j.jhepr.2020.100097DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7232085PMC

MELD or Sodium MELD: A Comparison of the Ability of Two Scoring Systems to Predict Outcomes After Transjugular Intrahepatic Portosystemic Shunt Placement.

AJR Am J Roentgenol 2020 May 20:1-8. Epub 2020 May 20.

Department of Internal Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, MN.

The purpose of this study was to compare the ability of the model for end-stage liver disease (MELD) and sodium MELD (MELD-Na) scoring systems to predict outcomes after transjugular intrahepatic portosystemic shunt (TIPS) placement. Two hundred and nineteen consecutive patients who underwent TIPS placement were retrospectively reviewed. The primary outcomes were death within 30 days and 90 days after TIPS placement (30- and 90-day mortality, respectively), and secondary outcomes included death within 365 days after TIPS placement (365-day mortality), length of hospital stay, and readmission to the hospital within 30 days of TIPS placement. Read More

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http://dx.doi.org/10.2214/AJR.19.21726DOI Listing

The Pull-Through Technique for Recanalization of Transjugular Intrahepatic Portosystemic Shunt Dysfunction.

Gastroenterol Res Pract 2020 27;2020:9150173. Epub 2020 Apr 27.

Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515 Guangdong, China.

Purpose: To evaluate the technical efficacy and safety of the pull-through technique in recanalization of transjugular intrahepatic portosystemic shunt (TIPS) when standard transjugular approach is inaccessible.

Materials And Methods: A retrospective review of patients underwent TIPS revision via the pull-through technique was performed. Transhepatic directly punctured stent was conducted if the portal vein could not be accessed via standard transjugular approach. Read More

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http://dx.doi.org/10.1155/2020/9150173DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201481PMC

The Role of Spleen and Liver Elastography and Color-Doppler Ultrasound in the Assessment of Transjugular Intrahepatic Portosystemic Shunt Function.

Ultrasound Med Biol 2020 May 8. Epub 2020 May 8.

Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, UOC Gastroenterologia ed Endoscopia, Milan, Italy. Electronic address:

The reference standard for assessing transjugular intrahepatic portosystemic shunt (TIPS) function is venography with portosystemic pressure gradient (PPG) measurement. This procedure is invasive and expensive; thus, we assessed the feasibility, reproducibility and diagnostic accuracy of color-Doppler ultrasound (CDUS) and spleen and liver stiffness (LS) measurements for identifying TIPS dysfunction. Twenty-four patients (15 undergoing TIPS placement and nine undergoing TIPS revision) consecutively underwent CDUS examination and LS and spleen stiffness (SS) determination by transient elastography (TE) and point shear-wave elastography (pSWE). Read More

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http://dx.doi.org/10.1016/j.ultrasmedbio.2020.04.007DOI Listing

Diagnosis and Management of Iatrogenic Hemobilia Secondary to Transjugular Intrahepatic Portosystemic Shunt Procedure.

Cureus 2020 Apr 10;12(4):e7629. Epub 2020 Apr 10.

Radiology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, ITA.

A patient with end-stage liver disease and subsequent refractory ascites was treated with a transjugular intrahepatic portosystemic shunt (TIPS) procedure. The procedure was complicated by massive gastrointestinal hemorrhage with associated rettorragia. Computed tomography angiography (CT-A) was performed and revealed haemobilia due to an artero-biliary fistula between the right hepatic artery and an intrahepatic biliary branch. Read More

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http://dx.doi.org/10.7759/cureus.7629DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213657PMC

Transjugular intrahepatic portosystemic shunt versus endoscopic therapy for prevention of variceal rebleeding in patients with hepatocellular carcinoma meeting the Milan criteria.

Eur J Gastroenterol Hepatol 2020 May 8. Epub 2020 May 8.

Objective: Transjugular intrahepatic portosystemic shunt (TIPS) and endoscopic therapy (ET) have been recommended to prevent variceal rebleeding due to cirrhotic portal hypertension. However, which one is better for patients with hepatocellular carcinoma (HCC) remains controversial. Hence, we aimed to compare the clinical outcomes of these two treatments for these subpopulation. Read More

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http://dx.doi.org/10.1097/MEG.0000000000001750DOI Listing

Applying the original model for end-stage liver disease score rather than the model for end-stage liver disease-Na score for risk stratification prior to transjugular intrahepatic portosystemic shunt procedures.

Eur J Gastroenterol Hepatol 2020 May 8. Epub 2020 May 8.

Division of Gastrointestinal and Liver Diseases, Keck School of Medicine of University of Southern California, Los Angeles, California, USA.

Objective: The model for end-stage liver disease (MELD) score can be used to predict survival of patients undergoing transjugular intrahepatic portosystemic shunt procedures (TIPS). The effect of hyponatremia on survival resulted in the development of the MELD-Na score. The aim of this study is to compare the prognostic value of MELD and MELD-Na scores in predicting post-TIPS outcomes. Read More

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http://dx.doi.org/10.1097/MEG.0000000000001760DOI Listing
May 2020
2.152 Impact Factor

Impact of PTFE-covered stent position and extension on TIPS patency.

Abdom Radiol (NY) 2020 May 11. Epub 2020 May 11.

Perelman School of Medicine - University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA.

Purpose: The objectives of this study were to determine the effects of expanded polytetrafluoroethylene (PTFE)-covered stent location and TIPS extension on primary patency.

Methods: This retrospective cohort study examined patients with PTFE-covered TIPS creation between 07/2002 and 06/2016. Clinical information and patency outcomes at 24 months were extracted. Read More

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http://dx.doi.org/10.1007/s00261-020-02566-8DOI Listing

Does Obesity Affect Outcomes of Transjugular Intrahepatic Portosystemic Shunt Placement?

Dig Dis Sci 2020 May 6. Epub 2020 May 6.

Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, OH, USA.

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http://dx.doi.org/10.1007/s10620-020-06276-5DOI Listing

Machine Learning Offers Exciting Potential for Predicting Postprocedural Outcomes: A Framework for Developing Random Forest Models in IR.

J Vasc Interv Radiol 2020 Jun 4;31(6):1018-1024.e4. Epub 2020 May 4.

Division of Interventional Radiology, Department of Diagnostic Imaging, Providence, Rhode Island.

Purpose: To demonstrate that random forest models trained on a large national sample can accurately predict relevant outcomes and may ultimately contribute to future clinical decision support tools in IR.

Materials And Methods: Patient data from years 2012-2014 of the National Inpatient Sample were used to develop random forest machine learning models to predict iatrogenic pneumothorax after computed tomography-guided transthoracic biopsy (TTB), in-hospital mortality after transjugular intrahepatic portosystemic shunt (TIPS), and length of stay > 3 days after uterine artery embolization (UAE). Model performance was evaluated with area under the receiver operating characteristic curve (AUROC) and maximum F1 score. Read More

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http://dx.doi.org/10.1016/j.jvir.2019.11.030DOI Listing

Causes and Rates of 30-Day Readmissions After Transjugular Intrahepatic Portosystemic Shunts.

AJR Am J Roentgenol 2020 May 6:1-7. Epub 2020 May 6.

Department of Radiology, Division of Vascular and Interventional Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, 1 Deaconess Rd, WCC 308, Boston, MA 02215.

The purpose of this study was to investigate the causes and rates of 30-day readmission after transjugular intrahepatic portosystemic shunt (TIPS) at a single liver transplant center. We reviewed 165 TIPS procedures performed between 2003 and 2013. After excluding patients who died during the index admission ( = 16), any readmission within 30 days of discharge was identified, and cause of readmission was determined. Read More

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http://dx.doi.org/10.2214/AJR.19.21732DOI Listing

Transjugular intrahepatic portosystemic shunt in cirrhotic patients with portal vein thrombosis.

Eur J Gastroenterol Hepatol 2020 Jun;32(6):762-763

Department of Diagnostic Radiology, University Hospitals Cleveland Medical center, Cleveland, Ohio, USA.

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http://dx.doi.org/10.1097/MEG.0000000000001680DOI Listing

Comparison of the effectiveness of 11 mainstay treatments for secondary prophylaxis of variceal bleeding in patients with cirrhosis: A network meta-analysis.

Authors:
Yu Kong Liang Shi

Exp Ther Med 2020 Jun 1;19(6):3479-3496. Epub 2020 Apr 1.

Endoscopy Division, Department of General Surgery, Cangzhou Central Hospital, Cangzhou, Hebei 061001, P.R. China.

The purpose of the present study was to compare the effectiveness of the transjugular intrahepatic portosystemic shunt (TIPS), endoscopic options, medications and mainstay combination therapies for patients with cirrhosis who have had at least one episode of variceal haemorrhage. The PubMed, Embase, Cochrane Library and Web of Science databases, as well as the reference lists of relevant articles, were searched to identify eligible studies. P-scores, that were based solely on the point estimates and standard errors of the network estimates, were performed to rank all treatments, on a scale from 0 (worst) to 1 (best). Read More

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http://dx.doi.org/10.3892/etm.2020.8633DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7185170PMC

Endotipsitis: a rare case of endovascular infection with ESBL .

BMJ Case Rep 2020 Apr 27;13(4). Epub 2020 Apr 27.

Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.

Endotipsitis is a vegetative endovascular infection of a transjugular intrahepatic portosystemic shunt (TIPS). There is currently no uniformly accepted diagnostic criterion, and most cases are diagnosed by clinical diagnosis of recurrent bacteraemia in patients with TIPS and no identifiable source after appropriate investigation. We present a case of 62-year-old man in whom endotipsitis was suspected clinically after emergent TIPS placement complicated by TIPS thrombosis, need for TIPS revision and recurrent bacteraemia. Read More

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http://dx.doi.org/10.1136/bcr-2019-233972DOI Listing

Behcet's Disease With Budd-Chiari Syndrome and Challenges in Its Management.

ACG Case Rep J 2020 Mar 19;7(3):e00352. Epub 2020 Mar 19.

Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.

Budd-Chiari syndrome may rarely occur as a complication of Behcet's disease, and presentation with thrombosis of both inferior vena cava (IVC) and hepatic veins is rarer still. We present a young woman with Behcet's disease who presented with acute Budd-Chiari syndrome, with thrombosis of IVC and all 3 hepatic veins. An IVC stent was placed, followed by a transjugular intrahepatic portosystemic shunt through the IVC stent. Read More

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http://dx.doi.org/10.14309/crj.0000000000000352DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162122PMC

Transjugular intrahepatic portosystemic shunt placement in an infant weighing less than 22 pounds.

Diagn Interv Imaging 2020 Apr 16. Epub 2020 Apr 16.

Department of Radiology, Hopital de la Timone, 13005 Marseille, France; University of-Aix Marseille, Jardin du Pharo, 13007 Marseille, France.

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http://dx.doi.org/10.1016/j.diii.2020.03.012DOI Listing

Serum levels of bone sialoprotein correlate with portal pressure in patients with liver cirrhosis.

PLoS One 2020 17;15(4):e0231701. Epub 2020 Apr 17.

Department of Gastroenterology/Hepatology, Charité University Medicine Berlin, Berlin, Germany.

Liver cirrhosis represents the common end-stage of chronic liver diseases regardless of its etiology. Patients with compensated disease are mostly asymptomatic, however, progression to a decompensated disease stage is common. The available stratification strategies are often unsuitable to identify patients with a higher risk for disease progression and a limited prognosis. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0231701PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164617PMC

Is 70 the new 50? Complications and outcomes of transjugular intrahepatic portosystemic shunt in older versus younger patients.

Abdom Radiol (NY) 2020 Apr 15. Epub 2020 Apr 15.

Banner Advanced Liver Disease and Transplant Institute, Banner University Medical Center - Phoenix, 1441 N. 12th St., Phoenix, AZ, 85006, USA.

Background: An increased risk of complications of TIPS in patients older than 65 years of age has been described, but data is limited. The objective of this study was to determine if the rate of complications post-TIPS differs in patients 65 or younger, compared to those older than 65 years of age.

Methods: A retrospective chart review was performed for all patients who underwent TIPS procedure at Banner-University Medical Center Phoenix, from 2010 to 2018, specifically focusing on complications and outcomes post-TIPS. Read More

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http://dx.doi.org/10.1007/s00261-020-02533-3DOI Listing

Transjugular intrahepatic portosystemic shunt for a patient with chylothorax in cryptogenic/metabolic cirrhosis.

Hepatobiliary Pancreat Dis Int 2020 Mar 20. Epub 2020 Mar 20.

Section of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy. Electronic address:

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http://dx.doi.org/10.1016/j.hbpd.2020.03.008DOI Listing

Hospital readmission following transjugular intrahepatic portosystemic shunt: a 14-year single-center experience.

Gastroenterol Rep (Oxf) 2020 Apr 28;8(2):98-103. Epub 2019 Nov 28.

Department of Radiology, Cleveland Clinic, Cleveland, OH, USA.

Background: Placement of a transjugular intrahepatic portosystemic shunt (TIPS) is a relatively common procedure used to treat complications of portal hypertension. However, only limited data exist regarding the hospital-readmission rate after TIPS placement and no studies have addressed the causes of hospital readmission. We therefore sought to identify the 30-day hospital-readmission rate after TIPS placement at our institution and to determine potential causes and predictors of readmission. Read More

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http://dx.doi.org/10.1093/gastro/goz062DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136714PMC

Can pretransplant TIPS be harmful in liver transplantation? A propensity score matching analysis.

Surgery 2020 Apr 5. Epub 2020 Apr 5.

Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address:

Background: Transjugular intrahepatic portosystemic shunt has been established as an effective treatment for complicated portal hypertension. This retrospective study investigated the effect of pretransplant transjugular intrahepatic portosystemic shunt placement on intraoperative graft hemodynamics and surgical outcomes after liver transplantation.

Methods: Of 1,081 patients who underwent liver transplantation between January 2007 and June 2017 at Cleveland Clinic (OH, USA), 130 patients had transjugular intrahepatic portosystemic shunt placement before liver transplant. Read More

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http://dx.doi.org/10.1016/j.surg.2020.02.017DOI Listing

The role of a multidisciplinary team in the management of portal hypertension.

BMC Gastroenterol 2020 Apr 3;20(1):83. Epub 2020 Apr 3.

Department of Gastroenterology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 0086200032, China.

Background: Gastroesophageal variceal hemorrhage is the most severe complication of portal hypertension, with a high mortality rate. The current recommendations for gastroesophageal varices include pharmacological treatment, endoscopic treatment, transjugular intrahepatic portosystemic shunt (TIPS) placement, and splenectomy with devascularization surgery. Multidisciplinary team (MDT) comprises of a group of medical experts and specialists across a range of disciplines, providing personalized and targeted patient care tailored to each individual's condition, circumstances, and expectations. Read More

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http://dx.doi.org/10.1186/s12876-020-01203-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7119157PMC

Treatment of Bleeding Gastric Varices by Endoscopic Cyanoacrylate Injection: A Developing-country Perspective.

Cureus 2020 Feb 20;12(2):e7062. Epub 2020 Feb 20.

Gastroenterology, Jinnah Postgraduate Medical Centre, Karachi, PAK.

Introduction Gastric varices (GV) are less commonly seen but bleed more severely than esophageal varices (EV). Transjugular intrahepatic portosystemic shunt (TIPS), alcohol injection, and N-butyl-2-cyanoacrylate (NBCA) are generally used for GV bleed management. NBCA is usually injected endoscopically and is known to be quite successful in the treatment of GV bleeding. Read More

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http://dx.doi.org/10.7759/cureus.7062DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7089629PMC
February 2020

Transjugular Intrahepatic Portosystemic Shunt for a Challenging Pregnancy.

Am J Gastroenterol 2020 Mar 26. Epub 2020 Mar 26.

Division of Gastroenterology and Hepatology, Duke University School of Medicine, Durham, North Carolina, USA.

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http://dx.doi.org/10.14309/ajg.0000000000000602DOI Listing

Systemic MCP-1 Levels Derive Mainly From Injured Liver and Are Associated With Complications in Cirrhosis.

Front Immunol 2020 11;11:354. Epub 2020 Mar 11.

Department of Internal Medicine 1, University Hospital, University Bonn, Bonn, Germany.

Monocyte chemotactic protein-1 (MCP-1) is a potent chemoattractant for monocytes. It is involved in pathogenesis of several inflammatory diseases. Hepatic MCP-1 is a readout of macrophage activation. Read More

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http://dx.doi.org/10.3389/fimmu.2020.00354DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078155PMC

Clinical management of type C hepatic encephalopathy.

United European Gastroenterol J 2020 Jun 26;8(5):536-543. Epub 2020 Feb 26.

Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.

Type-C hepatic encephalopathy is a complex neurological syndrome, characteristic of patients with liver disease, causing a wide and complex spectrum of nonspecific neurological and psychiatric manifestations, ranging from a subclinical entity, minimal hepatic encephalopathy, to a deep form in which a complete alteration of consciousness can be observed: overt hepatic encephalopathy. Overt hepatic encephalopathy occurs in 30-40% of patients. According to the time course, hepatic encephalopathy is subdivided into episodic, recurrent and persistent. Read More

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http://dx.doi.org/10.1177/2050640620909675DOI Listing

Computed tomography-based score model/nomogram for predicting technical and midterm outcomes in transjugular intrahepatic portosystemic shunt treatment for symptomatic portal cavernoma.

World J Clin Cases 2020 Mar;8(5):887-899

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

Background: Transjugular intrahepatic portosystemic shunt (TIPS) may be technically difficult in patients with cavernous transformation of the portal vein (CTPV). Computed tomography (CT) is widely used for assessing the situation of the portal vein and its tributaries before TIPS, and an ultrasound-based Yerdel grading system has been developed, which is deemed useful for liver transplantation. Therefore, we hypothesized that a CT-based CTPV scoring system could be useful for predicting technical and midterm outcomes in TIPS treatment for symptomatic portal cavernoma. Read More

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http://dx.doi.org/10.12998/wjcc.v8.i5.887DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7062625PMC

Intractable parastomal bleeding in a portal hypertensive patient managed by direct sclerotherapy: a case report.

Gastroenterol Hepatol Bed Bench 2020 ;13(1):90-94

Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center(ADIR), Tehran University of Medical Sciences, Tehran, Iran.

Patients with a stoma have 5% chance of developing parastomal varices, which tend to repetitive massive and life-threatening hemorrhages. Treatment of choice in parastomal varices have not been established, while Transjugular Intrahepatic Portosystemic Shunt (TIPS) has been revealed as the most successful measure. We report a hemodynamically unstable patient with a history of Ulcerative Colitis (UC) and Primary Sclerosing Cholangitis (PSC) with colostomy, because of colon cancer who presented with massive parastomal bleeding. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069542PMC
January 2020

The combination of balloon-assisted antegrade transvenous obliteration and transjugular intrahepatic portosystemic shunt for the management of cardiofundal varices hemorrhage.

Eur J Gastroenterol Hepatol 2020 May;32(5):656-662

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

Objectives: In this study, we propose a modified balloon-occluded retrograde transvenous obliteration (BRTO) strategy - balloon-assisted antegrade transvenous obliteration (BAATO), and explore the feasibility, efficacy and safety of BAATO combined with transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of cardiofundal varices (GOV2 or IGV1) hemorrhage.

Materials And Methods: In this retrospective cohort study, 15 patients with cardiofundal varices hemorrhage who received BAATO combined with TIPS procedures, from August 2017 to September 2019 in our center, were enrolled. They consisted of seven patients with GOV2 and eight patients with IGV1. Read More

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http://dx.doi.org/10.1097/MEG.0000000000001705DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147412PMC

Balloon-occluded retrograde transvenous obliteration of colonic varices: a case report.

CVIR Endovasc 2020 Mar 16;3(1):17. Epub 2020 Mar 16.

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore.

Background: Ectopic varices are uncommon and typically due to underlying liver cirrhosis. They can be located in the duodenum, small intestines, colon or rectum, and may result in massive haemorrhage. While established guidelines exist for the management of oesophageal and gastric variceal bleeding, this is currently lacking for colonic varices. Read More

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http://dx.doi.org/10.1186/s42155-020-00108-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073350PMC

[Clinical application and efficacy of TIPS combined with AngioJet mechanical thrombectomy for liver cirrhosis with extensive portal vein thrombosis].

Zhonghua Yi Xue Za Zhi 2020 Feb;100(7):533-537

Department of Interventional Radiology, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450000, China.

To assess the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with AngioJet mechanical thrombectomy for liver cirrhosis with extensive portal vein thrombosis. From March 2018 to April 2019, a total of 11 patients with liver cirrhosis and extensive portal vein thrombosis were treated by TIPS combined with AngioJet mechanical thrombectomy, including 6 males and 5 females, with the age of 37-71 (46±9) years old, 3 cases of Child-Pugh grade A, 8 cases of grade B and 0 cases of grade C. The intraoperative immediate thrombus clearance rate, perioperative complication rate, postoperative thrombus recurrence rate, rebleeding rate, the incidence of hepatic encephalopathy and the rate of stent patency of all cases were collected and analyzed. Read More

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http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2020.07.011DOI Listing
February 2020

Streamlining radioembolization in UNOS T1/T2 hepatocellular carcinoma by eliminating lung shunt estimation.

J Hepatol 2020 Jun 5;72(6):1151-1158. Epub 2020 Mar 5.

Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL; Department of Surgery, Division of Transplantation, Comprehensive Transplant Center, Northwestern University, Chicago, IL; Department of Medicine, Division of Medical Oncology, Northwestern University, Chicago, IL. Electronic address:

Background & Aims: Pre-treatment Tc-99m macroaggregated albumin (MAA) scans are routinely performed prior to transarterial radioembolization (TARE) to estimate lung shunt fraction (LSF) and lung dose. In this study, we investigate LSF observed in early hepatocellular carcinoma (HCC) and provide the scientific rationale for eliminating this step from routine practice.

Methods: Patients with HCC who underwent Y90 from 2004 to 2018 were reviewed. Read More

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http://dx.doi.org/10.1016/j.jhep.2020.02.024DOI Listing

Gastrointestinal Bleeding on Call: Questions and Answers and One Person's Opinions.

Authors:
Brian Funaki

Semin Intervent Radiol 2020 Mar 4;37(1):31-34. Epub 2020 Mar 4.

Department of Radiology, Section of Vascular and Interventional Radiology, University of Chicago Medicine, Chicago, Illinois.

Gastrointestinal (GI) bleeding represents one of the more morbid forms of hemorrhage that interventional radiologists deal with on an on-call basis. Bleeding from the GI tract takes many forms and has many etiologies. While venous bleeds from varices are often treated emergently with placement of a transjugular intrahepatic portosystemic shunt, arterial hemorrhages are treated most effectively with embolization procedures. Read More

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http://dx.doi.org/10.1055/s-0039-3402018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7056341PMC

Emergent Transjugular Intrahepatic Portosystemic Shunt Creation in Acute Variceal Bleeding.

Semin Intervent Radiol 2020 Mar 4;37(1):3-13. Epub 2020 Mar 4.

Department of Radiology, University of Illinois at Chicago, Chicago, Illinois.

Emergent transjugular intrahepatic portosystemic shunt (TIPS) creation is most commonly employed in the setting of acute variceal hemorrhage. Given a propensity for decompensation, these patients often require a multidisciplinary, multimodal approach involving prompt diagnosis, pharmacologic therapy, and endoscopic intervention. While successful in the majority of cases, failure to medically control initial bleeding can prompt interventional radiology consultation for emergent portal decompression via TIPS creation. Read More

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http://dx.doi.org/10.1055/s-0039-3402015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7056345PMC

Transjugular intrahepatic portosystemic stent-shunt in the management of portal hypertension.

Gut 2020 Feb 29. Epub 2020 Feb 29.

The Royal Free Sheila Sherlock Liver Centre, UCL Institute for Liver and Digestive Health, London, UK.

These guidelines on transjugular intrahepatic portosystemic stent-shunt (TIPSS) in the management of portal hypertension have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the Liver Section of the BSG. The guidelines are new and have been produced in collaboration with the British Society of Interventional Radiology (BSIR) and British Association of the Study of the Liver (BASL). The guidelines development group comprises elected members of the BSG Liver Section, representation from BASL, a nursing representative and two patient representatives. Read More

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http://dx.doi.org/10.1136/gutjnl-2019-320221DOI Listing
February 2020
14.660 Impact Factor

Comparison of the Effects of TIPS versus BRTO on Bleeding Gastric Varices: A Meta-Analysis.

Can J Gastroenterol Hepatol 2020 11;2020:5143013. Epub 2020 Feb 11.

Radiology Intervention Department, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

. Upper gastrointestinal bleeding is a threat to patients with gastric varices (GVs). Previous studies have concluded that both transjugular intrahepatic portosystemic shunt (TIPS) and balloon-occluded retrograde transvenous obliteration (BRTO) are effective treatments for patients with GV. Read More

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http://dx.doi.org/10.1155/2020/5143013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036113PMC
February 2020

Refractory Hepatic Hydrothorax in Chronic Hepatitis C Controlled by Direct-acting Antivirals.

Korean J Gastroenterol 2020 Feb;75(2):98-102

Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.

Hepatic hydrothorax is a transudative pleural effusion that complicates advanced liver cirrhosis. Patients refractory to medical treatment plus salt restriction and diuretics are considered to have refractory hepatic hydrothorax and may require transjugular intrahepatic portosystemic shunt (TIPS) or liver transplant. Successful antiviral therapy reduces the incidence of some complications of cirrhosis secondary to HCV infection. Read More

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http://dx.doi.org/10.4166/kjg.2020.75.2.98DOI Listing
February 2020

TIPS Modification in the Management of Shunt-Induced Hepatic Encephalopathy: Analysis of Predictive Factors and Outcome with Shunt Modification.

J Clin Med 2020 Feb 19;9(2). Epub 2020 Feb 19.

Institute of Clinical Radiology, University Hospital Muenster, D-48149 Muenster, Germany.

Purpose: To evaluate predictive parameters for the development of Hepatic Encephalopathy (HE) after Transjugular Intrahepatic Portosystemic Shunt (TIPS) placement and for success of shunt modification in the management of shunt-induced HE.

Methods: A retrospective analysis of all patients with TIPS ( = 344) has been performed since 2011 in our university liver center. = 45 patients with HE after TIPS were compared to = 48 patients without HE after TIPS (case-control-matching). Read More

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http://dx.doi.org/10.3390/jcm9020567DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073830PMC
February 2020

Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Refractory Transudative Chylothorax due to Liver Cirrhosis.

Case Rep Med 2020 7;2020:2581040. Epub 2020 Feb 7.

Department of Pulmonary/Critical Care, West Virginia University, Charleston, WV, USA.

Chylothorax is an infrequent type of pleural effusion, typically exudative, caused by obstruction or laceration of the thoracic duct by malignancy, trauma, or thoracic surgery. Transudative chylous pleural effusions are extremely rare. We report a case of a 63-year-old male with recurrent transudative chylothorax secondary to cirrhosis that completely resolved with transjugular intrahepatic portosystemic shunting (TIPS). Read More

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http://dx.doi.org/10.1155/2020/2581040DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029287PMC
February 2020

Pentraxin-3 is not related to disease severity in cirrhosis and hepatocellular carcinoma patients.

Clin Exp Med 2020 May 20;20(2):289-297. Epub 2020 Feb 20.

Department of Internal Medicine I, Regensburg University Hospital, 93042, Regensburg, Germany.

The acute-phase protein pentraxin-3 (PTX3) is a component of the innate immune system. Inflammation and tissue injury increased PTX3 in the injured liver, and accordingly, circulating PTX3 was induced in patients with chronic liver diseases. In the present study, PTX3 protein was determined in systemic, hepatic, and portal vein plasma of patients with liver cirrhosis to assess a possible association between hepatic PTX3 release and extent of liver injury. Read More

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http://dx.doi.org/10.1007/s10238-020-00617-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7181432PMC

What's new in portal hypertension?

Liver Int 2020 Feb;40 Suppl 1:122-127

Liver Unit, Hospital Italiano, Buenos Aires, Argentina.

Portal hypertension is defined as increased pressure in the portal venous system. The most common cause of portal hypertension is cirrhosis. In this setting, there is an increase in intrahepatic resistance leading to an increase in portal pressure. Read More

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http://dx.doi.org/10.1111/liv.14366DOI Listing
February 2020

[Transjugular intrahepatic portosystemic shunt for the treatment cavernous transformation of the portal vein with vareceal bleeding].

Zhonghua Yi Xue Za Zhi 2020 Feb;100(5):387-390

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

To evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt(TIPS) for the treatment of patients with cavernous transformation of portal vein (CTPV) with vareceal bleeding. From September 2016 to June 2018, a total of 21 patients suffered CTPV complicated with vareceal bleeding were admitted to First Affiliated Hospital of Zhengzhou University. TIPS were performed combined with percutaneous transhepatic portal vein assist. Read More

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http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2020.05.014DOI Listing
February 2020

Radiation exposure during transjugular intrahepatic portosystemic shunt creation in patients with complete portal vein thrombosis or portal cavernoma.

Radiol Med 2020 Feb 18. Epub 2020 Feb 18.

Radiology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi, 5, 90127, Palermo, PA, Italy.

Background: This study aims to evaluate radiation exposure in patients with complete portal vein thrombosis (CPVT) or portal cavernoma (PC) undergoing transjugular intrahepatic portosystemic shunt (TIPS) creation using real-time ultrasound guidance for portal vein targeting.

Materials And Methods: This is a single institution retrospective analysis. Between August 2009 and September 2018, TIPS was attempted in 49 patients with CPVT or PC. Read More

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http://dx.doi.org/10.1007/s11547-020-01155-5DOI Listing
February 2020
1.368 Impact Factor

Chronic Budd-Chiari syndrome in Behçet's disease successfully managed with transjugular intrahepatic portosystemic shunt: a case report and literature review.

Clin J Gastroenterol 2020 Feb 17. Epub 2020 Feb 17.

Venous Thromboembolism Unit, Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, C/. Doctor Esquerdo, 46, 28007, Madrid, Spain.

Budd-Chiari syndrome (BCS) is characterized by an obstruction of hepatic venous outflow from small hepatic veins to inferior vena cava, caused by acute thrombosis or its fibrous sequellae. An underlying myeloproliferative neoplasm is present in 50% of cases. Clinical manifestations are widely variable, from asymptomatic to fulminant episodes. Read More

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http://dx.doi.org/10.1007/s12328-020-01106-7DOI Listing
February 2020