Effect of Transjugular Intrahepatic Portosystemic Shunt Creation on Pulmonary Gas Exchange in Patients with Hepatopulmonary Syndrome: A Prospective Study

Tsauo, Jiaywei; Zhao, He; Zhang, Xiaowu; Ma, Huaiyuan; Jiang, Meng; Weng, Ningna; Xiao, Li

doi:10.1016/j.jvir.2018.09.017

Cited by 16 publications

(14 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hepatorenal syndrome was defined as functional renal injury developing in advanced liver disease [ 2 ]. Hepatopulmonary syndrome is defined as an arterial oxygenation defect induced by intrapulmonary vascular dilatation associated with liver disease and/or portal hypertension [ 3 ].…”

Section: Methodsmentioning

confidence: 99%

Transjugular intrahepatic portosystemic shunt: a meta-analysis of 8 mm versus 10 mm stents.

Huang¹,

Zhao²,

Wei³

et al. 2021

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

Introduction Transjugular intrahepatic portosystemic shunt (TIPS) is an approach that is used to alleviate portal hypertension-related symptoms. The optimal stent diameter for TIPS remains controversial. Aim To assess outcomes in patients who underwent TIPS using 8 mm and 10 mm stents. Material and methods The PubMed, Embase, and Cochrane Library databases were queried for all pertinent studies. The meta-analysis was conducted using RevMan v5.3. This meta-analysis was registered at the PROSPERO website (Number: CRD42020212392). Results Eighty-two potentially relevant articles were initially detected, with seven of these ultimately being included in this meta-analysis. Patients in the 10 mm stent group exhibited a significantly higher Δ portosystemic pressure gradient ( Δ PPG) relative to the 8 mm group (p = 0.04), whereas no differences between groups were observed with respect to postoperative hepatic encephalopathy (HE, p = 0.25), re-bleeding (p = 0.82), liver transplantation (p = 0.45), or mortality (p = 0.43) rates. The TIPS dysfunction rate was significant lower in the 10 mm group (p = 0.01). In Asian studies, the postoperative HE rate was found to be significantly lower in the 8 mm group relative to the 10 mm group (p = 0.02), whereas all other endpoints were comparable between these groups. In Western studies, Δ PPG values were significantly greater in the 10 mm group (p < 0.0001), whereas all other endpoint data were comparable between these groups. Conclusions TIPS with 10 mm stents provides a lower TIPS dysfunction rate. However, 8 mm stents may be recommended for Asian patients, as they can decrease the risk of postoperative HE.

show abstract

Section: Methodsmentioning

confidence: 99%

Transjugular intrahepatic portosystemic shunt: a meta-analysis of 8 mm versus 10 mm stents.

Huang¹,

Zhao²,

Wei³

et al. 2021

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

show abstract

“…No drug has shown efficacy in controlling this syndrome. TIPS appear to induce transient but not definitive improvements [ 39 ]. Currently, the only definitive treatment is liver transplantation, which is effective even in patients with severe HPS [ 40 ].…”

Section: Cardiopulmonary Complications In Cirrhosismentioning

confidence: 99%

Management of Liver Decompensation in Advanced Liver Disease (Renal Impairment, Liver Failure, Adrenal Insufficiency, Cardiopulmonary Complications)

Téllez

Guerrero

2022

Clin Drug Investig

View full text Add to dashboard Cite

Systemic complications often occur in patients with advanced liver disease. In particular, the development of renal complications (acute kidney injury, hepatorenal syndrome), acute-on-chronic liver failure, cardiopulmonary diseases, or relative adrenal insufficiency can be serious in patients with advanced liver disease and may determine the patient’s quality of life and prognosis. Therefore, the early diagnosis of possible complications is the key to the prompt initiation of specific treatments that can improve quality of life and survival. For this purpose, networking with reference centers where multidisciplinary units are available is essential so that every patient is evaluated in clinical discussions involving specialists from different fields.

show abstract

“…TIPS creation has been previously described (13). In brief, a transjugular approach was used to advance a transjugular liver access set (RUPS-100; Cook Medical, Bloomington, Indiana) into the hepatic vein or inferior vena cava, and the portal vein in the contralateral lobe of the tumor was punctured under fluoroscopic monitoring without intravascular ultrasound assistance.…”

Section: Tips Creationmentioning

confidence: 99%

Transjugular Intrahepatic Portosystemic Shunt Creation for the Prevention of Gastric Variceal Rebleeding in Patients with Hepatocellular Carcinoma: A Multicenter Retrospective Study

Tsauo

Tie

Xue

et al. 2021

Journal of Vascular and Interventional Radiology

Self Cite

View full text Add to dashboard Cite

Purpose: To evaluate the effectiveness and safety of transjugular intrahepatic portosystemic shunt (TIPS) creation for the prevention of gastric variceal rebleeding in patients with hepatocellular carcinoma (HCC). Materials and Methods:This multicenter retrospective study included 126 cirrhotic patients (mean age, 54.1 ± 10.2 years; 110 men) with HCC who underwent TIPS creation for the prevention of gastric variceal rebleeding. Of these, 110 (87.3%) patients had gastroesophageal varices and 16 (12.7%) patients had isolated gastric varices. Thirty-five (27.8%) patients had portal vein tumor thrombus.Results: TIPS creation was technically successful in 124 (98.4%) patients. Rebleeding occurred in 26 (20.6%) patients during the follow-up period. The 6-week and 1-year actuarial probabilities of patients remaining free of rebleeding were 98.3% ± 1.2% and 81.2% ± 3.9%, respectively. Forty-nine (38.8%) patients died during the follow-up period. The 6-week and 1-year actuarial probabilities of survival were 98.4 ± 1.1% and 65.6 ± 4.4%, respectively. Two (1.6%) patients had major procedure-related complications, including acute liver failure (n ¼ 1) and intra-abdominal bleeding (n ¼ 1). Thirty-three (26.2%) patients had at least 1 episode of overt hepatic encephalopathy during the follow-up period. Shunt dysfunction occurred in 15 (11.9%) patients after a median follow-up time of 11.4 months (range, 1.4-41.3 months). Lung metastasis occurred in 3 (2.4%) patients, 3.9-32.9 months after TIPS creation.Conclusions: TIPS creation may be effective and safe for the prevention of gastric variceal rebleeding in patients with HCC. ABBREVIATIONSGOV ¼ gastroesophageal varices, HCC ¼ hepatocellular carcinoma, HE ¼ hepatic encephalopathy, IGV ¼ isolated gastric varices, PSG ¼ portosystemic gradient, PVTT ¼ portal vein tumor thrombus, TIPS ¼ transjugular intrahepatic portosystemic shunt Interventional Radiology (W.-H.G.

show abstract

Effect of Transjugular Intrahepatic Portosystemic Shunt Creation on Pulmonary Gas Exchange in Patients with Hepatopulmonary Syndrome: A Prospective Study

Cited by 16 publications

References 27 publications

Transjugular intrahepatic portosystemic shunt: a meta-analysis of 8 mm versus 10 mm stents.

Transjugular intrahepatic portosystemic shunt: a meta-analysis of 8 mm versus 10 mm stents.

Management of Liver Decompensation in Advanced Liver Disease (Renal Impairment, Liver Failure, Adrenal Insufficiency, Cardiopulmonary Complications)

Transjugular Intrahepatic Portosystemic Shunt Creation for the Prevention of Gastric Variceal Rebleeding in Patients with Hepatocellular Carcinoma: A Multicenter Retrospective Study

Contact Info

Product

Resources

About