Diagnostic and therapeutic technology assessment. Transjugular intrahepatic portosystemic shunt (TIPS)

Miller-Catchpole, Robin

doi:10.1001/jama.273.23.1824

Cited by 11 publications

(4 citation statements)

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“…The improvement rate of gastric fundal varices after TIPS is only 50%, 21 whereas BRTO can completely obliterate gastric varices in most patients 19,20 . In addition, TIPS has limitations, such as a significant mortality rate, shunt occlusion, and hepatic encephalopathy 22 . BRTO or combined BRTO with PTO or TIO (named DBOE) may be promising for duodenal varices in the long term 9,17,23 .…”

Section: Discussionmentioning

confidence: 99%

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Clinical Characteristics and Treatment for Patients Presenting With Bleeding Duodenal Varices

Kakizaki

Toyoda

Ichikawa

et al. 2010

Digestive Endoscopy

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Section: Discussionmentioning

confidence: 99%

“…19,20 In addition, TIPS has limitations, such as a significant mortality rate, shunt occlusion, and hepatic encephalopathy. 22 BRTO or combined BRTO with PTO or TIO (named DBOE) may be promising for duodenal varices in the long term. 9,17,23 DBOE is theoretically a better treatment option than BRTO in the duodenum.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Treatment for Patients Presenting With Bleeding Duodenal Varices

Kakizaki

Toyoda

Ichikawa

et al. 2010

Digestive Endoscopy

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“…Sind endoskopische Verfahren nicht sofort verfü gbar oder nicht primär erfolgreich, so kann zur Blutstillung eine vorü bergehende Kompression der Varicen mittels Sengstakenoder Linton-Nachlaß-Sonde notwendig sein. Die akute Blutungssituation bei therapierefraktä rer Oesophagusvaricenblutung kann inzwischen als akzeptierte Indikation fü r die notfallmä ßige Plazierung eines TIPSS betrachtet werden [12]. Kommt es trotz adä quat durchgefü hrter endoskopischer Therapie innerhalb kurzer Zeit zu rezidivierenden Blutungen, dann ist eine Druckentlastung der Oesophagusvaricen erforderlich.…”

Section: Diskussionunclassified

Therapie der persistierenden Oesophagusvaricenblutung mittels intrahepatischem portosystemischem Stent-Shunt und kurzfristig folgender Lebertransplantation

Rosenthal

Böker

Manns

et al. 1997

Chirurg

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A 41-year-old patient with liver cirrhosis due to autoimmune hepatitis received an emergency transjugular portosystemic stent shunt for uncontrolled acute variceal hemorrhage. Because of markedly impaired liver function, liver transplantation was considered to be indicated and was performed on the following day. Intraoperatively, one of the intrahepatic metal stents migrated unnoticed into the pulmonary artery. The postoperative course was uncomplicated and the displaced stent was left in situ. Eighteen months after the transplantation the patient is well with normal liver function and no pulmonary problems.

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“…The fast-intra-variceal blood ow causes the rapid loss of sclerosing agents in endoscopic injection sclerotherapy (5). The application of TIPS is also not successful in all patients as it does not result in complete regression of gastric varices (6). In 1996, Kanagawa et al developed a less invasive and more reliable radiological procedure for treating gastric varices called balloon-occluded retrograde transvenous obliteration (BRTO) (7).…”

Section: Introductionmentioning

confidence: 99%

Short and long term outcomes of Balloon-occluded Retrograde Transvenous Obliteration (BRTO) in gastric varices patients: A retrospective analysis

Yakoob,

Omar,

John

et al. 2023

Preprint

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Background: Gastric variceal bleeding is one of the major complications of portal hypertension and is associated with high morbidity and mortality. This study aimed to evaluate the clinical outcomes of BRTO in gastric varices patients. Methods: Retrospective single-center study included 36 patients with moderate to large gastric varices who referred to intervention radiology for balloon-occluded retrograde transvenous obliteration (BRTO) procedure from January 2007 to December 2019. Short and long post procedural outcomes were analyzed for rebleeding, recurrence of gastric varices, worsening of esophageal varices, and mortality. Results: The mean age of the patients was 53.42 ± 9.8 years. Of the 36 patients, 30 (83.3%) were male. The majority of them had diabetes mellitus (21, 58.3%), hypertension (13, 36.1%), and coronary artery disease (3, 8.3%). Hepatitis C virus infection (15, 41.7%) was the predominant cause of liver cirrhosis. The follow-up CT showed immediate hemostasis in all patients except 2 (5.6%), who had hypovolemic shocks. Recurrence of gastric varices were observed in 4 (11.11%) patients, esophageal varices in 2 (5.55%) and both in 1 (2.77%) patient. Ascites and encephalopathy did not exacerbate in any of the patients. Hepatocellular carcinoma developed in two patients during the study period. 8 (22.2%) patients expired during the follow-up period. Kaplan Meir analysis showed that the median survival time was more than 69 months. Conclusion: BRTO may be a viable solution for prophylactic and therapeutic managing of fundal varices and ectopic variceal bleeding, especially when conventional treatments are unsuccessful or contraindicated.

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Diagnostic and therapeutic technology assessment. Transjugular intrahepatic portosystemic shunt (TIPS)

Cited by 11 publications

References 0 publications

Clinical Characteristics and Treatment for Patients Presenting With Bleeding Duodenal Varices

Clinical Characteristics and Treatment for Patients Presenting With Bleeding Duodenal Varices

Therapie der persistierenden Oesophagusvaricenblutung mittels intrahepatischem portosystemischem Stent-Shunt und kurzfristig folgender Lebertransplantation

Short and long term outcomes of Balloon-occluded Retrograde Transvenous Obliteration (BRTO) in gastric varices patients: A retrospective analysis

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