Use of early-TIPS for high-risk variceal bleeding: Results of a post-RCT surveillance study

García‐Pagán, Juan Carlos; Pascoli, Marco Di; Caca, Karel; Laleman, Wim; Bureau, C.; Appenrodt, Beate; Luca, Angelo; Zipprich, Alexander; Abraldes, Juan G.; Nevens, Frederik; Vinel, Jean Pierre; Sauerbruch, Tilman; Bosch, Jaime

doi:10.1016/j.jhep.2012.08.020

Cited by 256 publications

(230 citation statements)

References 11 publications

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“…Patients with HVPG levels >20 mmHg recorded within 24 h from bleeding [100] or in a Child-Pugh class C (<14 points) or actively bleeding at index endoscopy and in ChildPugh class B [101] have been suggested to have a poor outcome. In such high-risk subjects [101] receiving TIPS within 72 h from bleeding, failure to control bleeding or to prevent rebleeding and mortality were significantly lower (3% vs. 45% and 13% vs. 39% at 1 year, respectively) without an increased risk of HE [102][103][104]. However, in recent surveillance studies, a survival benefit was not observed [102,105], although it approached statistical significance in one [101].…”

Section: Tips Is Not Indicated For the Prophylaxis Of First Variceal mentioning

confidence: 90%

“…In such high-risk subjects [101] receiving TIPS within 72 h from bleeding, failure to control bleeding or to prevent rebleeding and mortality were significantly lower (3% vs. 45% and 13% vs. 39% at 1 year, respectively) without an increased risk of HE [102][103][104]. However, in recent surveillance studies, a survival benefit was not observed [102,105], although it approached statistical significance in one [101]. Votation 2.4 Votes in Favour 95%.…”

Section: Tips Is Not Indicated For the Prophylaxis Of First Variceal mentioning

confidence: 94%

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Consensus conference on TIPS management: Techniques, indications, contraindications

Fagiuoli

Bruno

Venon

et al. 2017

Digestive and Liver Disease

124

120

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a b s t r a c tThe trans jugular intrahepatic Porto systemic shunt (TIPS) is no longer viewed as a salvage therapy or a bridge to liver transplantation and is currently indicated for a number of conditions related to portal hypertension with positive results in survival. Moreover, the availability of self-expandable polytetrafluoroethylene (PTFE)-covered endoprostheses has dramatically improved the long-term patency of TIPS. However, since the last updated International guidelines have been published (year 2009) new evidence have come, which have open the field to new indications and solved areas of uncertainty. On this basis, the Italian Association of the Study of the Liver (AISF), the Italian College of Interventional Radiology-Italian Society of Medical Radiology (ICIR-SIRM), and the Italian Society of Anesthesia, Analgesia and Intensive Care (SIAARTI) promoted a Consensus Conference on TIPS. Under the auspices of the three scientific societies, the consensus process started with the review of the literature by a scientific board of experts and ended with a formal consensus meeting in Bergamo on June 4th and 5th, 2015. The final statements presented here were graded according to quality of evidence and strength of recommendations and were approved by an independent jury. By highlighting strengths and weaknesses of current indications to TIPS, the recommendations of AISF-ICIR-SIRM-SIAARTI may represent the starting point for further studies.

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Section: Tips Is Not Indicated For the Prophylaxis Of First Variceal mentioning

confidence: 90%

Section: Tips Is Not Indicated For the Prophylaxis Of First Variceal mentioning

confidence: 94%

Consensus conference on TIPS management: Techniques, indications, contraindications

Fagiuoli

Bruno

Venon

et al. 2017

Digestive and Liver Disease

124

120

View full text Add to dashboard Cite

show abstract

“…The Child-Pugh score has been widely used to identify a subgroup of patients at a high risk of early rebleeding and death. Cirrhotic patients with Child-Pugh class B and active bleeding on endoscopy or Child-Pugh class C will obtain more survival benefits from the early use of a transjugular intrahepatic portosystemic shunt (22)(23)(24). If the ALBI score could replace the role of the Child-Pugh score, it would be easier and more prompt to identify the candidates for an early transjugular intrahepatic portosystemic shunt for acute variceal bleeding.…”

Section: Limitationsmentioning

confidence: 99%

Albumin-bilirubin score for predicting the in-hospital mortality of acute upper gastrointestinal bleeding in liver cirrhosis: A retrospective study

Zou

Qi²,

Zhu³

et al. 2016

Turk J Gastroenterol

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“…18 Results, as measured by a decrease in HVPG, are encouraging, and early implantation seems -at least in the setting of acute variceal bleeding -to be more beneficial than standard medical and endoscopic therapy. 19 Although data is available for end-stage liver disease patients, its impact on the course of liver transplantation has not been extensively studied, and the extent of available literature is limited. 20 Notably, the implantation of an intrahepatic shunt should not complicate the technical feasibility of liver transplantation as long as there is no stent extension to the inferior caval vein that might complicate clamping during the operation.…”

Section: Introductionmentioning

confidence: 99%

The role of TIPS in the management of liver transplant candidates

et al. 2016

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Background: Transjugular intrahepatic portosystemic shunt (TIPS) implantation is used for treatment of several complications in patients with liver cirrhosis. Recent studies have identified a survival benefit for patients on the waiting list after TIPS implantation, but the optimal time point for TIPS implantation prior to orthotopic liver transplantation (OLT) has not been established. Study: This study retrospectively assessed patients undergoing TIPS implantation before or after listing for OLT at the Medical University of Vienna. n ¼ 98 patients with TIPS on the waiting list between January 1993 and December 2013 were identified (n ¼ 73 (74.5%) pre-listing TIPS, n ¼ 25 (25.5%) post-listing TIPS). A matched control group at the time of OLT without TIPS (n ¼ 60) was included. Conclusion: TIPS should be considered in all liver transplant candidates, since it can obviate the need for OLT and optimize bridging to OLT.

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Use of early-TIPS for high-risk variceal bleeding: Results of a post-RCT surveillance study

Cited by 256 publications

References 11 publications

Consensus conference on TIPS management: Techniques, indications, contraindications

Consensus conference on TIPS management: Techniques, indications, contraindications

Albumin-bilirubin score for predicting the in-hospital mortality of acute upper gastrointestinal bleeding in liver cirrhosis: A retrospective study

The role of TIPS in the management of liver transplant candidates

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