Complications During Transjugular Intrahepatic Portosystemic Shunt Creation

Shah, Rajesh P.; Sze, Daniel Y.

doi:10.1053/j.tvir.2016.01.007

Cited by 26 publications

(30 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…TIPSS implantation is a challenging and complex procedure performed in patients with advanced liver diseases . Numerous complications have been published, but a systematic evaluation is lacking.…”

Section: Discussionmentioning

confidence: 99%

“…It is hard to believe that, until now, only one original small study has been published almost 20 years ago that systematically investigated procedural‐ and shunt‐related complications . Instead, numerous case reports or small series of specific complications such as haemolysis, biliary or hepatic artery injury have been published and summarised in narrative reviews . A systematic overview over the entire spectrum of complications observed during the first decade of the TIPSS treatment is given in a review published in 1998 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Procedural and shunt‐related complications and mortality of the transjugular intrahepatic portosystemic shunt (TIPSS)

Bettinger

Schultheiß

Böettler

et al. 2016

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Procedural and shunt‐related complications and mortality of the transjugular intrahepatic portosystemic shunt (TIPSS)

Bettinger

Schultheiß

Böettler

et al. 2016

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

“…Speci cally, the average PPG in Viabahn group fell from 27.1 ± 5.2 mmHg to 9.6 ± 2.4 mmHg, and in Fluency group fell from 26.1 ± 5.5 mmHg to 10.2 ± 2.6 mmHg. No life-threatening complications such as hemoperitoneum, liver or renal failure was discovered during the perioperative period of TIPS procedure in all patients [24,25].…”

Section: Resultsmentioning

confidence: 99%

A New Choice for the Use of the Stents for Transjugular Intrahepatic Portosystemic Shunt Creation: Viabahn ePTFE covered stent/bare metal stent combination

Liu

Meng

Zhou

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Compare the clinical outcome of structure and function between insertion of transjugular intrahepatic portosystemic shunt (TIPS) created with the Viabahn ePTFE covered stent/bare metal stent (BMS) combination and Fluency ePTFE covered stent/BMS combination. Methods 101 consecutive patients undergone TIPS procedure from February 2016 to August 2018 in our center were analyzed retrospectively, 64 subjects were enrolled in Viabahn group and 37 were Fluency group. We caculated the TIPS geometry characteristics and evaluated the related occurrence of shunt dysfunction, survival, overt hepatic encephalopathy (OHE) and variceal rebleeding. Results The technical success rate was 100%. After TIPS insertion, the rate of shunt dysfunction during the first 3 months was significantly different between Viabahn group and Fluency group, which were respectively 1.6% and 13.5% (p = 0.024). And multivariate analysis indicated that the angle of portalvenous inflow (α) (HR = 1.060, 95%CI = 1.009–1.112, p = 0.020) was the only predictor of shunt dysfunction. Besides, after 3 months following TIPS insertion, the α angle distinctly increased from 20.9°±14.3° to 26.9°±20.1° (p = 0.005) in Fluency group but stayed unchanged in Viabahn group (from 21.9°±15.1° to 22.9°±17.6°, p = 0.798). Conclusions The occurence of shunt dysfunction was related to the angle of portalvenous inflow (α), because of the slighter effect on α angle, after TIPS inplanation, Viabahn ePTFE covered stent/BMS combination was more stable in structure and promised higher short-term stent patency compared to Fluency ePTFE covered stent/BMS combination.

show abstract

“…15 Duplex imaging is performed before the patient leaves the hospital, and the portal and hepatic blood flow velocities are measured as well as visualization of the stent's position. 1,[15][16][17][20][21][22] Figure 3 is a sonogram showing the position of the shunt within the liver. Figure 4 is a color Doppler image showing blood flow through the shunt, and Figure 5 is a spectral Doppler measurement of the blood flow velocity.…”

Section: Methodsmentioning

confidence: 99%

“…15 Stent stenosis can lead to failure that in turn can cause recurrent portal hypertension and/or variceal bleeding. 21 Stent thrombosis or occlusion can occur in approximately 10% to 15% of patients, which necessitates steps to remove the thrombosis by angiographic techniques or dilatation of the thrombosed section by balloon catheter. 22,23 Surgical removal of the thrombus may be attempted, but in some cases, liver transplant is the only treatment.…”

Section: Complicationsmentioning

confidence: 99%

Transjugular Intrahepatic Portosystemic Shunt: A Literature Review

Franklin

Simmons

Baker

2017

Journal of Diagnostic Medical Sonography

View full text Add to dashboard Cite

Interventional radiologist Josef Rösch is recognized as the creator of the transjugular intrahepatic portosystemic shunt (TIPS) procedure. In 1969, while performing transjugular cholangiography, he inadvertently initiated the approach. 1 Transjugular cholangiography is a procedure in which a catheter is introduced into the jugular vein and advanced through the superior vena cava, to the right atrium, and directed into the hepatic vein. Using the catheter, a needle is then introduced through the hepatic vein, into the liver, and passed into the bile ducts. The goal is to administer contrast into the biliary system to evaluate patency. This method was believed to be safer for the patient than puncturing the liver capsule because patients often experienced bleeding, ascites, and obstructive jaundice with the percutaneous liver technique. According to Rösch, 1 the procedure often experienced technical difficulties, and the needle would mistakenly puncture into the portal vein. The idea of shunting the portal system was developed and is currently used to treat portal hypertension, ascites, and variceal hemorrhage. 2 Anatomy and Physiology Normal liver vascularity includes the portal vein transporting blood into the liver from the bowel along with inflow from the hepatic artery. The hepatic veins drain the liver and transport blood into the inferior vena cava. The portal vein is responsible for supplying about two-thirds of the blood flow volume into the liver. 3 In the diseased liver, blood flow into the liver is often compromised due to fibrotic changes within the liver's parenchyma. The resistance to the movement of blood into the liver increases, which then increases the portal flow resistance. Over a period of time, the portal circulation is altered, and portal hypertension occurs. The resulting effects are debilitating and progressive. Portal hypertension creates a process where blood is shunted away from the liver. This blood is forced into small, thin vessels connected to veins in the esophagus, stomach, and rectal areas. 4 These thin, dilated vessels are called varices, and they often weaken and hemorrhage. Up to 50% of patients with cirrhosis will eventually form esophageal varices. 5 746338J DMXXX10.

show abstract

Complications During Transjugular Intrahepatic Portosystemic Shunt Creation

Cited by 26 publications

References 66 publications

Procedural and shunt‐related complications and mortality of the transjugular intrahepatic portosystemic shunt (TIPSS)

Procedural and shunt‐related complications and mortality of the transjugular intrahepatic portosystemic shunt (TIPSS)

A New Choice for the Use of the Stents for Transjugular Intrahepatic Portosystemic Shunt Creation: Viabahn ePTFE covered stent/bare metal stent combination

Transjugular Intrahepatic Portosystemic Shunt: A Literature Review

Contact Info

Product

Resources

About