Ten-year experience of transjugular intrahepatic portosystemic shunt for noncirrhotic portal hypertension

Regnault, David; d’Altéroche, Louis; Nicolas, Charlotte; Dujardin, Fanny; Ayoub, Jean; Perarnau, Jean Marc

doi:10.1097/meg.0000000000001067

Cited by 18 publications

(27 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The further bleeding rate (24%) in the INCPH cohort of the present study was similar with those reported in previous studies (28%), supporting that TIPSS creation is a highly effective therapy in controlling bleeding and preventing rebleeding. Overall, when compared to the results of patients with INCPH using nonselective beta blockers and/or endoscopic variceal ligation, TIPSS seems to have a better efficacy profile.…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

TIPSS for variceal bleeding in patients with idiopathic non‐cirrhotic portal hypertension: comparison with patients who have cirrhosis

et al. 2019

Aliment Pharmacol Ther

View full text Add to dashboard Cite

Background:In patients with idiopathic non-cirrhotic portal hypertension (INCPH), the usual recommended strategy for management of variceal bleeding is the same as that in cirrhosis. However, this policy has been challenged by the different natural history between INCPH and cirrhosis. Aim: To compare outcomes after transjugular intrahepatic portosystemic shunt (TIPSS) between INCPH and cirrhotic patients admitted for variceal bleeding. Methods: Between March 2001 and September 2015, 76 consecutive patients with biopsy-proven INCPH undergoing TIPSS for variceal bleeding in a tertiary-care centre were included. 76 patients with cirrhotic portal hypertension receiving TIPSS for variceal bleeding, and matched for age, sex, Child-Pugh class, stent type and index year of TIPSS creation served as controls.Results: Patients with INCPH, compared to those with cirrhosis, had significantly lower mortality (11% vs 36% at 5 years, adjusted HR, 0.37; 95% CI 0.15-0.87, P = 0.022), overt hepatic encephalopathy (16% vs 33% at 5 years, adjusted HR, 0.35; 95% CI 0.16-0.75, P = 0.007) and hepatic impairment, despite similar rates of further bleeding (33% vs 32% at 5 years, adjusted HR, 0.72; 95% CI 0.36-1.44, P = 0.358), and shunt dysfunction (35% vs 36% at 5 years, adjusted HR, 0.84; 95%

show abstract

Section: Discussionsupporting

confidence: 91%

“…The overt hepatic encephalopathy rate was 14% in our INCPH cohort, which was lower than those reported in previous studies (31%‐56%) . This discrepancy may be related to the more preserved liver function and use of 8‐mm diameter stents in a majority of our cohort.…”

Section: Discussioncontrasting

confidence: 80%

TIPSS for variceal bleeding in patients with idiopathic non‐cirrhotic portal hypertension: comparison with patients who have cirrhosis

et al. 2019

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

“…Its diagnostic criteria have been described previously, and rests on liver histology which shows an absence of cirrhosis and the presence of subtle lesions such as hepatoportal sclerosis or nodular regenerative hyperplasia 114. There are only six published observational studies on the utility of TIPSS in INCPH 2 115–119. The largest of these from China compared patients with INCPH (n=76) with a matched control group of cirrhotic patients (n=76) over a median follow-up of 34 months.…”

Section: Indications For Tipssmentioning

confidence: 99%

Transjugular intrahepatic portosystemic stent-shunt in the management of portal hypertension

Tripathi

Stanley

Hayes

et al. 2020

Gut

228

220

View full text Add to dashboard Cite

These guidelines on transjugular intrahepatic portosystemic stent-shunt (TIPSS) in the management of portal hypertension have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the Liver Section of the BSG. The guidelines are new and have been produced in collaboration with the British Society of Interventional Radiology (BSIR) and British Association of the Study of the Liver (BASL). The guidelines development group comprises elected members of the BSG Liver Section, representation from BASL, a nursing representative and two patient representatives. The quality of evidence and grading of recommendations was appraised using the GRADE system. These guidelines are aimed at healthcare professionals considering referring a patient for a TIPSS. They comprise the following subheadings: indications; patient selection; procedural details; complications; and research agenda. They are not designed to address: the management of the underlying liver disease; the role of TIPSS in children; or complex technical and procedural aspects of TIPSS.

show abstract

“…The cause of NRH, also found in cystic fibrosis, HIV infection, chronic granulomatous disease, and after solid organ transplantation is not known, and treatment is based mostly on lowering portal pressures. Transjugular intrahepatic portosystemic shunts have used, but with unclear success . Liver transplantation has been performed, but the outcome has not been very encouraging overall with recurrent disease in the transplanted liver in some .…”

Section: Clinical Spectrummentioning

confidence: 99%

“…Transjugular intrahepatic portosystemic shunts have used, but with unclear success. 61 Liver transplantation has been performed, but the outcome has not been very encouraging overall with recurrent disease in the transplanted liver in some. 62,63 Other liver conditions noted in some CVID patients are primary biliary cirrhosis and granulomatous disease.…”

Section: Liver Diseasementioning

confidence: 99%

Common variable immune deficiency: Dissection of the variable

Cunningham‐Rundles

2018

Immunological Reviews

View full text Add to dashboard Cite

Summary Starting about 60 years ago, a number of reports appeared that outlined the severe clinical course of a few adult subjects with profound hypogammaglobinemia. Puzzled by the lack of family history and adult onset of symptoms in most, the name “acquired” hypogammaglobinemia was given, but later altered to the current name common variable immune deficiency (CVID). Pathology reports remarked on the loss of lymph node architecture and paucity of plasma cells in lymphoid tissues in these subjects. While characterized by reduced serum IgG and IgA and often IgM, and thus classified amongst the B cell defects, an increasing number of cellular defects in these patients have been recognized over time. In the early years, severe respiratory tract infections commonly led to a shortened life span, but the wide spread availability of immune globulin concentrates for the last 25 years has improved survival. However, chronic non-infectious inflammatory and autoimmune conditions have now emerged as challenging clinical problems; these require further immunologic understanding and additional therapeutic measures. Recent study of this phenotypic syndrome have provided an increasingly fertile ground for the identification of autosomal recessive and now more commonly, autosomal dominant gene defects which lead to the loss of B cell development in this syndrome.

show abstract

Ten-year experience of transjugular intrahepatic portosystemic shunt for noncirrhotic portal hypertension

Abstract: TIPS is effective in NCPHT but can be technically difficult, especially in the case of cavernoma. Good liver function does not prevent the occurrence of long-term encephalopathy.

Cited by 18 publications

References 27 publications

TIPSS for variceal bleeding in patients with idiopathic non‐cirrhotic portal hypertension: comparison with patients who have cirrhosis

TIPSS for variceal bleeding in patients with idiopathic non‐cirrhotic portal hypertension: comparison with patients who have cirrhosis

Transjugular intrahepatic portosystemic stent-shunt in the management of portal hypertension

Common variable immune deficiency: Dissection of the variable

Contact Info

Product

Resources

About