Search Our Scientific Publications & Authors

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

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

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:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

JHEP Rep 2019 Aug 10;1(2):90-98. Epub 2019 May 10.

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

Background & Aims: Refractory ascites is the main reason for the implantation of a transjugular intrahepatic portosystemic shunt (TIPS) in liver cirrhosis, but ascites control by TIPS fails in a relevant proportion of cases. Here, we investigated whether routine parameters pre-TIPS can predict persistent ascites after TIPS implantation and whether persistent ascites predicts long-term clinical outcome.

Methods: A detailed retrospective analysis of 128 patients receiving expanded polytetrafluoroethylene-covered stents for the treatment of refractory ascites was performed. Read More

CVIR Endovasc 2020 Jan 8;3(1). Epub 2020 Jan 8.

Department of Surgery, Section of Transplant Surgery, University of Chicago, Chicago, IL, 60637, USA.

Background: Percutaneous trans-splenic portal vein recanalization (PVR) has been reported for facilitation of transjugular intrahepatic portosystemic shunts (TIPS), however has not been applied to patients undergoing direct intrahepatic portosystemic shunt (DIPS). We report the utilization of trans-splenic-PVR with DIPS creation in a patient with chronic portal and hepatic vein occlusions undergoing liver transplantation evaluation.

Case Presentation: A 48-year-old male with decompensated alcoholic cirrhosis complicated by refractory ascites, hepatic encephalopathy, and variceal bleeding underwent CT that demonstrated chronic occlusion of the hepatic veins (HV), extrahepatic portal vein (PV), and superior mesenteric vein (SMV). Read More

Liver Transpl 2020 May 22;26(5):651-661. Epub 2020 Mar 22.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.

The automated low-flow ascites pump (alfapump) is an implantable device that drains ascites directly into the urinary bladder. We studied its safety (absence of serious complications) and efficacy (decreased large-volume paracentesis [LVP] requirement and improved quality of life [QoL]) in the management of ascites in a cohort of North American patients with cirrhosis and recurrent ascites ineligible for transjugular intrahepatic portosystemic shunt (TIPS). QoL was measured by the Chronic Liver Disease Questionnaire (CLDQ) and Ascites Questionnaire (Ascites Q). Read More

Intern Emerg Med 2020 01 9;15(1):37-48. Epub 2020 Jan 9.

Department of Experimental and Clinical Medicine, University of Florence, Viale Morgagni 85, 50134, Florence, Italy.

Transjugular intrahepatic portosystemic shunt (TIPS) represents a very effective treatment of complications of portal hypertension. Established indications to TIPS in cirrhotic patients include portal hypertensive bleeding and refractory ascites. Over the years additional indications have been proposed, such as the treatment of vascular disease of the liver, hepatic hydrothorax, hepatorenal syndrome and bleeding from ectopic varices. Read More

Diagn Interv Imaging 2020 Jun 31;101(6):417-419. Epub 2019 Dec 31.

Department of Radiology, Nantes University Hospital and University of Medicine of Nantes, 1, place Alexis Ricordeau, 44093 Nantes, France.

J Pediatr Gastroenterol Nutr 2020 May;70(5):615-622

Department of Paediatric Hepatology, Gastroenterology and Transplantation.

Objectives: A proportion of children with chronic liver disease have severe portal hypertension (PH) and a preserved synthetic and biliary function. In our institution these children have been managed with transjugular intrahepatic portosystemic shunts (TIPS). We aimed to evaluate the long-term patency of TIPS placed in pediatric patients with PH. Read More

J Clin Gastroenterol 2019 Dec 23. Epub 2019 Dec 23.

Department of Radiology, University of Kentucky, Lexington, KY.

Introduction: Balloon-occluded retrograde transvenous obliteration (BRTO) and transjugular intrahepatic portosystemic shunt (TIPS) are well-validated techniques in the management of portal hypertensive gastric variceal bleeding when medical management alone is not sufficient. However, despite their effectiveness, the adverse effects from both procedures make each technique more suitable to different cohorts of patient's depending on presence or lack of certain comorbidities. This study aims to compare clinical outcomes of patients who have undergone both procedures for portal hypertensive gastric variceal bleeding. Read More

Zhonghua Yi Xue Za Zhi 2019 Dec;99(47):3737-3740

Department of Interventional Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, China.

To investigate the feasibility, efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) in the individualized treatment of patients with refractory ascites and variceal hemorrhage caused by portal hypertension. Prospective study of clinical data of 47 patients with portal hypertension and refractory ascites and variceal bleeding admitted to the Affiliated Hospital of Xuzhou Medical University from August 2017 to December 2018, 26 males and 21 females, aged 23-75 (52±14) years old. The Viabahn stent was used to control the diameter of the shunt and the preoperative interval of PPG after individualized TIPS was determined according to the preoperative liver function Child-Pugh classification. Read More

Hepatology 2020 May;71(5):1876-1878

Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX.

Ann Hepatol 2019 Dec 3. Epub 2019 Dec 3.

Liver Unit, Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy.

A 39-year-old female, liver transplanted for Autosomic Dominant Polycystic Kidney Disease (ADPKD) developed refractory ascites early after surgery, with frequent need of large-volume paracentesis. This was associated with severe sarcopenia and kidney impairment. Liver biopsy showed a sinusoidal congestion with a significant enlargement of hepatic portal veins. Read More

Eur J Gastroenterol Hepatol 2019 Dec 16. Epub 2019 Dec 16.

Department of Internal Medicine I, University Hospital Frankfurt, Frankfurt, Germany.

Objectives: Transjugular intrahepatic portosystemic shunt (TIPS) insertion is an established treatment to lower portal pressure. There are no obligatory evidence-based recommendations addressing procedure and anticoagulation. Therefore, a survey was performed to establish current practice at different German hospitals. Read More

Gastroenterology 2020 03 12;158(4):834-835. Epub 2019 Dec 12.

Alfred Hospital, Melbourne, Victoria, Australia.

GE Port J Gastroenterol 2019 Oct 15;26(6):420-424. Epub 2019 Feb 15.

Department of Gastroenterology, Porto University Hospital Centre, Porto, Portugal.

Background: Rectal varices are portosystemic collaterals that arise as a complication of portal hypertension. Despite their significant prevalence among cirrhotic patients, clinically important bleeding occurs only in a minority. Various treatment options are available, with endoscopic therapies being widely used, and both interventional radiology and surgery being considered for refractory bleeding rectal varices. Read More

Zhonghua Yi Xue Za Zhi 2019 Dec;99(45):3554-3557

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

To assess the feasibility and value of real-time image fusion technique guiding the procedure of transjugular intrahepatic portosystemic shunt(TIPS). From July 2017 to May 2018,a total of 48 consecutive patients complicated by portal venous hypertension due to cirrhosis who underwent TIPS were prospectively allocated into two groups that 27 cases underwent normal TIPS and 21 cases underwent image fusion guided TIPS. There were 25 males and 23 females with a mean age of 29-74(51±10) years. Read More

World J Gastroenterol 2019 Nov;25(43):6430-6439

Medical Department II-Gastroenterology, Hepatology, Infectious Diseases, Pulmonology, University of Leipzig Medical Center, Leipzig 04103, Saxony, Germany.

Background: Segmental intrahepatic cholestasis caused by transjugular intrahepatic portosystemic shunt (TIPS) (SIC-T), is a rare complication of this technique and only referred by case reports. Thus, we conducted a systematic, retrospective analysis to provide evidence regarding prevalence and consequences of this TIPS-induced bile duct compression.

Aim: To assess prevalence and outcome of SIC-T in a large TIPS-cohort. Read More

Ultrasound Med Biol 2020 Feb 26;46(2):216-224. Epub 2019 Nov 26.

Northwest Radiology, St. Vincent Health, Indianapolis, Indiana, USA. Electronic address:

Intravascular ultrasound (IVUS) is a proven and rapidly developing imaging modality that can be used for a multitude of both diagnostic and interventional purposes. By allowing for superior intraluminal characterization, compared with angiography, IVUS has emerged as a technically valuable tool in interventional procedures such as transjugular intrahepatic portosystemic shunt/direct intrahepatic portosystemic shunt, venous interventions (May Thurner stenting, inferior vena cava filter placement, recanalization in the setting of chronic venous thrombosis/insufficiency), percutaneous fenestration in the setting of aortic dissection and angioplasty. Additional applications evaluating coronary arteries and plaque morphology have been described, but are outside the scope of this review. Read More

Abdom Radiol (NY) 2020 02;45(2):556-562

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

Purpose: To explore the feasibility of fenestration in the treatment of shunt dysfunction after transjugular intrahepatic portosystemic shunt (TIPS).

Methods: Between February 2012 and December 2017, 12 TIPS patients with shunt dysfunction underwent fenestration to resolve recurrent portal hypertension with gastric variceal bleeding or ascites. The demographic data, operative data, postoperative recovery data, hemodynamic data, and complications were analyzed. Read More

Zhonghua Gan Zang Bing Za Zhi 2019 Oct;27(10):777-781

Department of Interventional Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, China.

To investigate the safety, feasibility, and preliminary clinical experience of ultrasonic guided percutaneous portal vein punctures combined bi-directional angiography in the treatment by transjugular intrahepatic portosystemic shunt(TIPS). From January 2016 to June 2018, 15 patients with TIPS from our hospital who were treated by ultrasonic guided percutaneous portal vein punctures combined with bi-directional angiography were enrolled,and were recruited as experimental group. During the same period, 30 patients who were treated by TIPS combined with traditional methods were enrolled, and were recruited as control group. Read More

Semin Roentgenol 2019 Oct 26;54(4):311-323. Epub 2019 Jun 26.

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

Within the broad spectrum of pediatric hepatobiliary disorders, hepatic vascular malformations, portal hypertension, and hepatic transplant interventions pose numerous challenges. The role of interventional radiology within each of these conditions is discussed herein, beginning with endovascular management of high flow hepatic vascular malformations. Next, while becoming less common in adult populations, surgical portoportal and portosystemic shunts remain prevalent in many pediatric centers. Read More

Ann Gastroenterol 2019 Nov-Dec;32(6):656. Epub 2019 Oct 1.

Department of Radiology, University Hospitals Leuven, Belgium.