Feasibility and Efficacy of Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Children

Giorgio, Angelo Di; Agazzi, Roberto; Alberti, Daniele; Colledan, M.; D’Antiga, Lorenzo

doi:10.1097/mpg.0b013e3182490c05

Cited by 58 publications

(58 citation statements)

References 22 publications

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“…Following TIPS, the Porto systemic gradient decreased to below 10 mmHg, portal hypertension complications resolved in 10 of 11, no clinically apparent encephalopathy developed; TIPS revision was necessary in 3 patients. Shunts were patent at follow-up (0.2-67 months) in 7 children without transplant and in 4 children (1.5-33 months) with transplant [220].…”

Section: Paediatric Patientsmentioning

confidence: 99%

“…Consequently, the length of the follow-up of children with severe cirrhotic PH is short. (2) Non-cirrhotic causes of portal hypertension instead are very common and long-standing, representing the main group of patients in the follow up for PH [220]. These patients usually have extra hepatic portal vein obstruction (EHPVO) and conditions characterized by the wide spectrum of the liver ductal plate malformation.…”

Section: Paediatric Patientsmentioning

confidence: 99%

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Consensus conference on TIPS management: Techniques, indications, contraindications

Fagiuoli

Bruno

Venon

et al. 2017

Digestive and Liver Disease

131

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: Paediatric Patientsmentioning

confidence: 99%

Section: Paediatric Patientsmentioning

confidence: 99%

Consensus conference on TIPS management: Techniques, indications, contraindications

Fagiuoli

Bruno

Venon

et al. 2017

Digestive and Liver Disease

131

120

View full text Add to dashboard Cite

show abstract

“…Finally, in children with intractable ascites caused by portal hypertension, the possibility of creating a transjugular intrahepatic portosystemic shunt (TIPS) can be considered [28]. The portal venous system is decompressed by creating and stenting an intrahepatic connection between a portal vein and a systemic vein (usually the right portal vein and the right hepatic vein).…”

Section: Management Of Ascitesmentioning

confidence: 99%

Interventional radiology in paediatric palliative care

Roebuck

2014

Pediatr Radiol

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Paediatric palliative care is a distinct subspecialty that offers treatment to children with many types of illness, including oncological, neurological and respiratory problems. Paediatric interventional radiologists can make a useful contribution to symptom management as part of a multidisciplinary team. Interventions for pain management include local ablation or other treatment of painful lesions, image-guided nerve blocks and the insertion of devices for the delivery of analgesic drugs. Various techniques are also available for the management of ascites, pleural effusions and other symptomatic complications of the underlying disease process.

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“…The transjugular intrahepatic portosystemic shunt (TIPS) has been introduced as an alternative safe management for complicated PH even in pediatrics [3, 4]. …”

Section: Introductionmentioning

confidence: 99%

Portal Hypertension in Childhood Bilateral Wilms' Tumor Survivor: An Excellent Indication for TIPS

Nakib

Calcaterra

Brunero

et al. 2013

Case Reports in Gastrointestinal Medicine

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Introduction. Increased pressure in portal venous system is relatively a rare complication after chemoradiotherapy for Wilms' tumor (WT). In paediatric population, feasibility and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in portal hypertension nonresponsive to medical or endoscopic treatment have been recently advocated. We report a case of TIPS positioning in a 15-year-old girl with portal hypertension as a long-term sequel of multimodality therapy in bilateral WT. Case Report. Two-year-old girl was diagnosed for bilateral WT. Right nephrectomy with left heminephrectomy and chemoradiotherapy were performed. At 7 years of age, the first gastrointestinal bleeding appeared, followed by another episode two years later, both were treated successfully with beta-blockers. At 15 years of age, severe unresponsive life-threatening gastroesophageal bleeding without hepatosplenomegaly was managed by TIPS. Reduction of the portosystemic pressure gradient was obtained. Conclusion. TIPS positioning for portal hypertension in long-term tumors' sequel is feasible and could be considered as an additional indication in paediatric patients.

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Feasibility and Efficacy of Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Children

Cited by 58 publications

References 22 publications

Consensus conference on TIPS management: Techniques, indications, contraindications

Consensus conference on TIPS management: Techniques, indications, contraindications

Interventional radiology in paediatric palliative care

Portal Hypertension in Childhood Bilateral Wilms' Tumor Survivor: An Excellent Indication for TIPS

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