Patency and reintervention rates during routine TIPSS surveillance

Abstract

The majority of TIPSS shunts will remain patent when regular portal venography, with appropriate intervention, is undertaken. Although there is a high reintervention rate this mainly takes the form of balloon angioplasty.

Contrast-enhanced ultrasound: a new method for TIPS follow-up

“…The major cause of stenosis of the TIPS tract is the development of pseudointimal hyperplasia in the TIPS parenchymal tract and intimal hyperplasia in the hepatic venous outflow [7]. It has been accepted that there is dysfunction when there is a reduction of greater than 50% of the shunt lumen, a portosystemic gradient higher than 12 mmHg [8,9]. The gold standard for evaluating TIPS morphology and function is shunt portography.…”

Clinical efficacy of transjugular intrahepatic portosystemic shunt created with covered stents with different diameters: Results of a randomized controlled trial

“…This procedure, however, involves two main drawbacks: the occurrence of shunt dysfunction and hepatic encephalopathy (HE), reported in 30-70% [1,4,[10][11][12][13] and 30-55% [14][15][16][17][18][19] of cirrhotic patients within the first year, respectively. Recently, the use of a new generation of covered stents overcame the problem of shunt dysfunction with significant improvement in TIPS patency and clinical efficacy [20][21][22][23][24][25][26][27][28][29][30].…”

Transjugular intrahepatic porto-systemic shunt in bleeding esophageal varices and refractory ascites. The first 4years experience in Assiut University Hospital

“…We improved our skills by: better pre-procedural interpretation of the radiological images, proper selection of the patients, and improvement of our practice with more cautious PV targeting, and good preparation of the material and equipments of various sizes, types and different manufacturers. Therapeutic approaches for patients with the BCS include medical management, percutaneous or transhepatic angioplasty of the narrowed hepatic vein or IVC web (9,10), TIPSS (11,12), surgical shunts (portal or mesenteric-systemic shunts) (13,14), and liver transplantation in selected patients. TIPSS provides instant decompression of both sinusoidal and splanchnic beds and facilitates arterial perfusion.…”