Echocardiography in patients with cirrhosis does not predict the clinical outcome after Transjugular Intrahepatic Portosystemic Stent-Shunt (TIPSS)

Armstrong, Matthew; Gohar, Farhan; Baker, G. Hamilton; Nightingale, P.G.; Greaves, D.; Dhaliwal, Amritpal; Mehrzad, Homoyon; Olliff, Simon; Schmidt, Daniela; Steeds, RP; Tripathi, Dhiraj

doi:10.1016/s0168-8278(17)31110-8

Cited by 2 publications

(1 citation statement)

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“…However, this study had the limitation of that the predictive role of echocardiography for the development of cardiac complications after TIPS was not evaluated. 76 A recent prospective study showed that cardiac decompensation occurred in 20% of LC patients treated with TIPS. BNP, NT-proBNP level, and echocardiography before TIPS implementation discriminated patients at high risk for such.…”

Section: Cardiac Dysfunctionmentioning

confidence: 99%

The role of transjugular intrahepatic portosystemic shunt in patients with portal hypertension: Advantages and pitfalls

Lee

2022

Clin Mol Hepatol

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Transjugular intrahepatic portosystemic shunt (TIPS) is an effective interventional procedure to relieve portal hypertension, which is the main mechanism for the development of complications of liver cirrhosis (LC), including variceal hemorrhage, ascites, and hepatorenal syndrome. However, the high incidence of adverse events after TIPS implementation limits its application in clinical practice. Esophageal variceal hemorrhage is one of the major indications for TIPS. Recently, preemptively performed TIPS has been recommended as several studies have demonstrated that TIPS significantly reduced mortality as well as rebleeding or failure to control bleeding in patients who are at high risk of treatment failure for bleeding control with endoscopic variceal ligation and vasoactive drugs. Meanwhile, recurrent ascites is another indication for TIPS with a proven survival benefit. TIPS may also be considered as an effective treatment for other LC complications, usually as an alternative therapy. Although there are concerns about the development of hepatic encephalopathy and hepatic dysfunction after TIPS implementation, careful patient selection using prognostic scores can lead to excellent outcomes. Assessments of cardiac and renal function prior to TIPS may also be considered to improve patient prognosis.

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Section: Cardiac Dysfunctionmentioning

confidence: 99%