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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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Hepatobiliary Pancreat Dis Int 2018 Dec 7;17(6):517-523. Epub 2018 Sep 7.

Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China. Electronic address:

Background: Treatment options for patients with cavernous transformation of portal vein (CTPV) are limited. This study aimed to evaluate the feasibility, efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) to prevent recurrent esophageal variceal bleeding in patients with CTPV.

Methods: We retrospectively analyzed 67 consecutive patients undergone TIPS from January 2011 to December 2016. Read More

Case Rep Radiol 2018 23;2018:9261268. Epub 2018 Aug 23.

Department of Radiology, Rutgers New Jersey Medical School, Newark, NJ, USA.

Transjugular intrahepatic portosystemic shunt (TIPS) is an alternative interventional procedure used to manage refractory Budd-Chiari syndrome (BCS) when conservative medical therapy has failed. However, TIPS is not always technically successful because of hepatic vein thrombosis and inability to catheterize the hepatic veins. In these situations, direct intrahepatic portosystemic shunt (DIPS) with access to the portal vein from the IVC has been shown to be a viable alternative that may ameliorate portal hypertension in these patients. Read More

Aliment Pharmacol Ther 2018 Oct 4;48(8):863-874. Epub 2018 Sep 4.

Brain-Liver Pitié-Salpêtrière Study Group (BLIPS), Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Paris, France.

Background: Hepatic encephalopathy (HE) may occur after transjugular intrahepatic portosystemic shunt (TIPSS) placement. Multimodal magnetic resonance imaging (MRI), combining anatomical sequences, diffusion tensor imaging (DTI) and H magnetic resonance spectroscopy, is modified in cirrhotic patients.

Aims: To describe multimodal MRI images before TIPSS, to assess if TIPSS induces changes in multimodal MRI, and to find predictors of HE after TIPSS in patients with cirrhosis. Read More

Eur J Radiol 2018 Sep 30;106:20-25. Epub 2018 Jun 30.

Department of Radiology, Amiens University Hospital, Avenue René Laennec, F-80054 Amiens Cedex 01, France.

Purpose: To evaluate the feasibility, safety and usefulness of 3D CBCT with a new injection protocol for targeting the portal vein during TIPS and to determine if it allows decreasing the duration of the procedure.

Materials And Methods: 3D CBCT was obtained during creation of TIPS in 15 patients (group 2). Portogram quality score was defined using a 5 points scale. Read More

J Vasc Interv Radiol 2018 09;29(9):1330-1331

Department of Interventional and Vascular Radiology, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL 33136.

Cardiovasc Intervent Radiol 2018 Dec 21;41(12):1925-1934. Epub 2018 Aug 21.

Diagnostic Radiology, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.

Purpose: We sought to evaluate patient radiation exposure during complex liver interventional procedures performed with newer angiography equipment.

Materials And Methods: We conducted a retrospective study of transjugular intrahepatic portosystemic shunt (TIPS) creations and liver tumor embolizations performed in our new angiography suite (Discovery IGS740, GE Healthcare). T tests were used to compare air kerma-area product (P) and reference plane air kerma (K) in the new room versus data from historical rooms and previous studies (including the RAD IR study). Read More

Obstet Gynecol 2018 Oct;132(4):882-887

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, the Department of Radiology, Division of Interventional Radiology, the Department of Anesthesia, Division of Women's Anesthesia, the Department of General Surgery, Division of Abdominal Transplant Surgery, the Department of Medicine, Division of Hematology and Oncology, the Department of Radiology, Division of Cardiothoracic Imaging, and the Department of Medicine, Division of Gastroenterology, Duke University Medical Center, Durham, North Carolina.

Background: Portal hypertension in pregnancy is associated with elevated risk of variceal hemorrhage. Ectopic varices, those located outside the esophagus or stomach, are rare but have a high risk of associated maternal morbidity or mortality.

Case: A 31-year-old woman, gravida 2 para 0010, with cirrhosis and portal hypertension was found to have abdominal wall ectopic varices on third-trimester obstetric ultrasonography. Read More

Radiat Prot Dosimetry 2018 Aug 14. Epub 2018 Aug 14.

Slovenian Radiation Protection Administration, Ministry of Health, Ajdovšcina 4, Ljubljana, Slovenia.

Peak skin doses to patients undergoing interventional radiological procedures in a 3-year period were assessed to identify the most critical procedures and evaluate probability for occurrence of radiation-induced tissue injuries. Data of 7607 patients were reviewed, identifying those with cumulative air kerma at a reference point (Ka,r) exceeding 3 Gy. Observed tissue injuries in patients with exceeded levels were gathered by a questionnaire. Read More

Semin Intervent Radiol 2018 Aug 6;35(3):206-214. Epub 2018 Aug 6.

Section of Interventional Radiology, Department of Radiology, Northwestern Memorial Hospital, Chicago, Illinois.

Recently, new techniques and devices in transjugular intrahepatic portosystemic shunt (TIPS) placement have emerged that can improve upon the standard procedure. Ultrasound guidance during TIPS with intracardiac echocardiography (ICE), placement of controlled expansion (CX) stents, and portal vein recanalization (PVR) via transsplenic access are three techniques with new data supporting their implementation. ICE guidance can improve the technical success of difficult cases, decrease procedure time, and decrease complications such as capsular puncture, hemobilia, and hepatic artery injury. Read More

Semin Intervent Radiol 2018 Aug 6;35(3):203-205. Epub 2018 Aug 6.

Section of Interventional Radiology, Department of Radiology, Northwestern Memorial Hospital, Chicago, Illinois.

Extrahepatic abdominal surgery in patients with portal hypertension is associated with a high rate of perioperative complications and death due to the increased risk of liver failure, perioperative bleeding, and ascites. One proposed method to facilitate surgery in these patients is with preoperative placement of a transjugular intrahepatic portosystemic shunt (TIPS). By decompressing the portal circulation, this presurgical measure would theoretically decrease the potential for bleeding and improve the ability to control ascites in the perioperative and postoperative period. Read More

Semin Intervent Radiol 2018 Aug 6;35(3):194-197. Epub 2018 Aug 6.

Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University, Chicago, Illinois.

Individuals with end-stage liver disease are susceptible to a myriad of highly morbid complications, including hepatorenal syndrome (HRS). This specific type of renal dysfunction in patients with underlying liver disease occurs in pathophysiologically normal kidneys and is a result of renal vasoconstriction secondary to diminished renal blood flow in the setting of worsening hepatic dysfunction. Liver transplantation is curative; shortage of available organs limits access to this beneficial therapy. Read More

Semin Intervent Radiol 2018 Aug 6;35(3):185-193. Epub 2018 Aug 6.

Department of Interventional Radiology, Loyola University Medical Center, Maywood, Illinois.

Gastric variceal hemorrhage is a life-threatening complication of portal hypertension with a poorer prognosis compared with esophageal variceal hemorrhage. The presence of an infradiaphragmatic portosystemic shunt, often a gastrorenal shunt, allows for treatment with retrograde transvenous obliteration (RTO). RTO is an evolving treatment strategy, which includes balloon-assisted RTO, plug-assisted RTO, and coil-assisted RTO, for both gastric variceal hemorrhage and hepatic encephalopathy. Read More

Semin Intervent Radiol 2018 Aug 6;35(3):169-184. Epub 2018 Aug 6.

Department of Radiology, University of Illinois Hospital & Health Sciences System, Chicago, Illinois.

Variceal hemorrhage is a feared complication of portal hypertension, with high rates of morbidity and mortality. Optimal management requires a thoughtful, multidisciplinary approach. In cases of refractory or recurrent esophageal hemorrhage, endovascular approaches such as transjugular intrahepatic portosystemic shunt (TIPS) have a well-defined role. Read More

Semin Intervent Radiol 2018 Aug 6;35(3):165-168. Epub 2018 Aug 6.

Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, Illinois.

Ascites is the most common complication of cirrhosis, impairs quality of life, and carries a poor prognosis. Transjugular intrahepatic portosystemic shunt (TIPS) is a well-validated therapy for refractory ascites and is superior at reducing the accumulation of fluid compared with paracentesis. More recent evidence has shown that TIPS also provides an improved transplant-free survival compared with paracentesis. Read More

Semin Intervent Radiol 2018 Aug 6;35(3):160-164. Epub 2018 Aug 6.

Department of Interventional Radiology, Northwestern Memorial Hospital, Chicago, Illinois.

Interventional radiology's role in the management of portal hypertension in the pediatric population differs from the management of adult portal hypertension. In the pediatric population, portal hypertension is frequently secondary to thrombosis and cavernous transformation of the extrahepatic portion of the portal vein. Transjugular intrahepatic portosystemic shunt can be utilized to manage portal hypertension in children with intrinsic liver disease that results in cirrhosis and portal hypertension, and is often used as a bridge to transplant. Read More

AJR Am J Roentgenol 2018 Sep 7;211(3):684-688. Epub 2018 Aug 7.

1 Department of Radiology, David Geffen School of Medicine at UCLA, 10833 LeConte Ave, Box 951350, Los Angeles, CA 90095-1721.

Objective: The purpose of this study was to investigate a new method-the portal vein enhancement curve-for quantifying portal vein blood flow immediately at transjugular intrahepatic portosystemic shunt (TIPS) creation using digital subtraction angiography images and its potential usefulness as a predictor of TIPS revision.

Conclusion: The portal vein flow time constant, Q, was significantly different (p = 0.002) between patients grouped by 12-month revision (TIPS angioplasty, TIPS reduction, no revision); Q was higher in patients who required TIPS reduction. Read More

Acad Radiol 2018 Aug 1. Epub 2018 Aug 1.

Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China. Electronic address:

Rationale And Objectives: As a special movement disorder, hepatic myelopathy (HM) is characterized by spastic paraperesis and may be secondary to transjugular intrahepatic portosystemic shunt (TIPS). The prediction and diagnosis of HM is difficult due to largely unknown neuropathological underpinnings and a lack of specific biomarkers. We aimed to delve into the alterations in motor system of HM patients' brain and their potential clinical implication. Read More

Cardiovasc Intervent Radiol 2019 Jan 2;42(1):78-86. Epub 2018 Aug 2.

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

Objectives: To evaluate short-term clinical efficacy, complications and possible passive stent expansion of transjugular intrahepatic portosystemic shunt (TIPS) creation using the new controlled expansion ePTFE covered stent (VCX), for portal hypertension complications.

Methods: Between 7/2016 and 3/2018, 75 patients received TIPS using VCX. Thirty-nine patients with VCX dilated with an 8-mm angioplasty balloon underwent computed tomography (CT) study during follow-up and CT data were used to measure stent diameter. Read More

Hum Immunol 2018 Oct 30;79(10):716-723. Epub 2018 Jul 30.

Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt am Main, Germany. Electronic address:

Advanced liver diseases are associated with impaired intestinal barrier function, which results in bacterial influx via the portal vein to the liver, causing hepatic and systemic inflammation. Little is known about possible concomitant trafficking of immune cells from the intestines to the liver. We therefore performed a comprehensive immunophenotyping study of the portal venous versus peripheral blood compartment in patients with liver cirrhosis who received a transjugular intrahepatic portosystemic stent shunt (TIPS). Read More

J Vasc Interv Radiol 2018 08;29(8):1204-1205

Central Oregon Radiology Associates, Bend, Oregon.

Eur J Gastroenterol Hepatol 2018 12;30(12):1441-1446

Department of Vascular and Interventional Radiology.

Objective: To evaluate the outcome of early transjugular portosystemic shunt (TIPS) treatment in patients with a trial-compatible high-risk variceal bleeding and secondly to disclose other predictors of early mortality.

Materials And Methods: A cohort study was conducted on patients referred for a TIPS procedure with or without combined variceal embolization to control acute esophageal variceal bleeding. A total of 32 patients with Child-Pugh C score less than 14 or Child-Pugh B plus active bleeding at endoscopy, admitted for early-TIPS treatment (<72 h), were included. Read More

Rofo 2018 08 25;190(8):740-746. Epub 2018 Jul 25.

Dept. of Radiology, University Hospital Bonn, Germany.

Background: Acute portal vein thrombosis is a potentially fatal condition. In symptomatic patients not responding to systemic anticoagulation, interventional procedures have emerged as an alternative to surgery. This study sought to retrospectively evaluate initial results of interventional treatment of acute portal vein thrombosis (aPVT) using a transjugular interventional approach. Read More

Rofo 2018 08 25;190(8):701-711. Epub 2018 Jul 25.

Department of Radiology, Medical School & Hospital, University of Bonn, Germany.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is a non-selective portosystemic shunt created using endovascular techniques. During recent years technical improvements and new insights into pathophysiology have modified indications for TIPS placement. In this article we therefore want to discuss current knowledge. Read More

Eur Radiol 2019 Feb 23;29(2):699-706. Epub 2018 Jul 23.

Institute of Interventional Radiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.

Objectives: To assess the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) with and without adjunctive embolisation in managing cardiofundal varices bleeding.

Methods: The retrospective study comprised 82 patients (54 men; mean age 53.9 years; mean Model of End-stage Liver Disease score 9. Read More

Diagn Interv Imaging 2018 Nov 20;99(11):765-767. Epub 2018 Jul 20.

Department of Radiology, S. Maria della Misericordia Hospital, University of Perugia Medical School, Sant'Andrea delle Fratte, 06132 Perugia, Italy. Electronic address: