Primary constrained TIPS for treating refractory ascites or variceal bleeding secondary to hepatic cirrhosis

Rabei, Rana; Mathesovian, S; Tasse, J.; Madassery, Sreekumar; Arslan, Bülent; Turba, Ulku C.; Ahmed, Osman

doi:10.1259/bjr.20170409

Cited by 6 publications

(6 citation statements)

References 29 publications

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“…However, as the older generation VIATORR was a commonly used and clinically well-known stent, understanding of how the new VCX compares to the previous VIATORR version in vitro, may help clinicians to better predict its behavior in situ. More relevant would also be the comparison between VCX and the balloon-expandable stents recently used instead of VIATORR [ 18 , 19 ]. However, this is not possible because the test method used is only suitable for nitinol stents.…”

Section: Discussionmentioning

confidence: 99%

How Controlled is the Expansion of VIATORR CX?

Dell

Menne

Wagenpfeil

et al. 2023

Cardiovasc Intervent Radiol

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Purpose To investigate and compare the physical properties of the new generation Gore VIATORR-Controlled Expansion Endoprosthesis (VCX) to those of the predecessor VIATORR stent in an in vitro experimental setup. Materials and Methods A total of 12 stents (8 VCX; 4 VIATORR; GORE, USA) were examined. Radial resistive force (RRF) and chronic outward force (COF) were assessed using a radial force testing machine (RX-650, Machine Solutions Inc., USA). To assess the radial forces of the VCX above 8 mm, balloon expansion was performed between cycles. Results All VCX stents show an abrupt decrease in COF at an external diameter of 8.3 mm; RRF decreases likewise at an external diameter of 8.5 mm. The predecessor VIATORR stent without the “controlled expansion” feature shows linear radial force reduction until full expansion at a diameter of 10 mm. The physical properties of the VCX can be altered by balloon modulation. Point of COF (RRF) reduction shifts to 8.5 mm (8.6 mm), 8.6 mm (8.8 mm) and 9.3 mm (9.6 mm) following modulation with a 8 mm, 9 mm and 10 mm balloon. Conclusions The VCX shows an abrupt and disproportionate decrease in COF and RRF at an external diameter of 8.3 mm, thus passive expansion to its nominal diameter of 10 mm is not to be expected. By means of balloon dilatation the physical properties of the stent can be altered, enabling customized TIPS creation. The previous VIATORR stent shows continuous COF and RRF until total expansion.

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Section: Discussionmentioning

confidence: 99%

How Controlled is the Expansion of VIATORR CX?

Dell

Menne

Wagenpfeil

et al. 2023

Cardiovasc Intervent Radiol

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“…However, the complications of TIPS are hepatic encephalopathy, bleeding, biliary and hepatocellular insufficiency, and malposition or stent occlusion. The complication rate of TIPS was as high as 20% in the early 2010s, but there have been fewer procedure-related complications of TIPS in the recent studies [55,56]. Liver transplantation may be indicated for patients in whom all the above treatments fail.…”

Section: Parastomal Varicesmentioning

confidence: 99%

Current Management of Intestinal Stomas and Their Complications

Tsujinaka

Tan

Miyakura

et al. 2020

J Anus Rectum Colon

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Inappropriate stoma site, improper management of stoma, and stoma complications lead to diminished quality of life of ostomates. Healthcare professionals involved in stoma creation and/or care should have the fundamental and updated knowledge of the management of stomas and their complications. This review article consists of the following major sections: principles of perioperative patient management, early complications, and late complications. In the "principles of perioperative patient management" section, the current concepts and trends in preoperative education, stoma site marking, postoperative education, and patient educational resources are discussed. In the "early complications" section, we have focused on the etiology and current management of ischemia/necrosis, fluid and electrolyte imbalances, mucocutaneous separation, and retraction. In the "late complications" section, we have focused on the etiology and current management of parastomal hernia, stoma prolapse, parastomal varices, and pyoderma gangrenosum. Pre-and postoperative patient education facilitates the patient's independence in stoma care and resumption of normal activities. Healthcare providers should have basic skills and updated knowledge on the management of stomas and complications of stomas, to act as the first crisis manager for ostomates.

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“…Several randomized controlled trials showed that ascites was effectively controlled by TIPS with a 1-year mortality rate of less than 5%. [24,25]…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic totally extraperitoneal (TEP) inguinal hernia repair in patients with liver cirrhosis accompanied by ascites

Wang

et al. 2019

Medicine

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To investigate the feasibility, efficacy, and safety of laparoscopic totally extraperitoneal (TEP) repair in patients with inguinal hernia accompanied by liver cirrhosis.Between October 2015 and May 2018, 17 patients with liver cirrhosis who underwent TEP repair were included in this study. The baseline characteristics, perioperative data, and recurrence were retrospectively reviewed.Seventeen patients with a mean duration of 18.23 ± 16.80 months were enrolled. All TEP repairs were successful without conversion to trans-abdominal pre-peritoneal (TAPP) surgery or open repair, but 4 patients had peritoneum rupture during dissection. The mean operation time was 54.23 ± 10.51 minutes for unilateral hernia and 101.25 ± 13.77 minutes for bilateral hernias. We found 2 cases with contralateral inguinal hernia and 2 cases with obturator hernia during surgery. The rate of complication was 17.65% (3/17), 2 of 3 cases were Child-Turcotte-Pugh C with large ascites. During a follow-up of 19.29 ± 9.01 months, no patients had recurrence and chronic pain, but 2 patients died because of the progression of underlying liver disease.Early and elective inguinal hernia repair is feasible and effective for patients with liver cirrhosis. TEP is a feasible and safe repair option for cirrhotic patients in experienced hands.

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Primary constrained TIPS for treating refractory ascites or variceal bleeding secondary to hepatic cirrhosis

Cited by 6 publications

References 29 publications

How Controlled is the Expansion of VIATORR CX?

How Controlled is the Expansion of VIATORR CX?

Current Management of Intestinal Stomas and Their Complications

Laparoscopic totally extraperitoneal (TEP) inguinal hernia repair in patients with liver cirrhosis accompanied by ascites

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