Transjugular intrahepatic portosystemic shunt: Experiences at a liver transplantation center

Hidajat, N.; Vogl, Th.; Stobbe, H; Schmidt, Jörg; Wex, Cora; Lenzen, Romana; Berg, T.; Félix, R.

doi:10.1080/028418500127345712

Cited by 21 publications

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“…Several authors have used the presence of hepatic malignancy as a part of their exclusion criteria. 31,32 It is believed that prognosis is a central factor for excluding patients with diffuse or extensive focal malignancy from undergoing TIPS. The patient population in the current study included patients with considerable tumor burden and limited life expectancy, and TIPS was used to palliate complications of portal hypertension.…”

Section: Discussionmentioning

confidence: 99%

Transjugular intrahepatic portosystemic shunts: Experience in the oncology setting

Wallace

Madoff

Ahrar

et al. 2004

Cancer

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BACKGROUNDTransjugular intrahepatic portosystemic shunt (TIPS) placement has emerged as an effective and minimally invasive method of treating portal hypertension and its associated complications. To the authors' knowledge there is limited documentation of its use for percutaneous shunting in patients with hepatic and extrahepatic malignancies. The current study reports the authors' experience with TIPS in the oncology setting.METHODSThirty‐eight patients with cancer underwent TIPS procedures. Nineteen patients had a history of hepatic malignancy. All medical records and imaging studies were reviewed retrospectively. The indication for TIPS, the presence of malignancy, procedural details, complications, survival, and treatment success were assessed.RESULTSPrimary technical success was accomplished in 37 of 38 patients (97%) without technical procedure‐related complications. Hepatic encephalopathy occurred in 15 of 34 patients (44%), with 3 patients requiring shunt reduction. Premature shunt occlusion (< 30 days) occurred in 3 patients (8%). Recurrent hemorrhage occurred in 1 of 19 patients (5%), and ascites and hepatic hydrothorax resolved or improved subjectively in 9 of 12 patients (75%). Shunts traversed malignancy in 9 patients, and varying degrees of portal compromise were encountered in 12 patients (32%). The overall 30‐day and 90‐day survival rates were 84% and 60%, respectively. There was a statistically significant difference in 90‐day survival rates for patients who had ascites and hepatic hydrothorax indications (27%) compared with patients who had variceal and portal gastropathy indications (84%; P = 0.0075). In addition, the 90‐day survival rate was significantly lower in patients who had primary hepatic malignancies (36%) compared with the remainder of the study population (74%; P = 0.0077), and it was significantly lower in patients who had model for end‐stage liver disease (MELD) scores ≥ 12 (P = 0.0020).CONCLUSIONSTIPS was performed safely for patients with cancer without increasing rates of procedure‐related complications. However, some patients subgroups, such at those with malignancy and ascites, primary hepatic malignancy, or MELD scores ≥ 12, had the lowest 90‐day survival rates. Cancer 2004. © 2004 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Transjugular intrahepatic portosystemic shunts: Experience in the oncology setting

Wallace

Madoff

Ahrar

et al. 2004

Cancer

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“…The transjugular intrahepatic portosystemic shunt (TIPS) is also the most frequent procedure for recurrent variceal bleeding in patients with portal hypertension in whom endoscopic treatment is insufficient [4], but TIPS alone might be insufficient to prevent recurrent bleeding. The combination of TIPS and embolization has been described as very satisfactory in the prevention of recurrent bleeding from esophagogastric or rectal varices [5,6]. However, emergent percutaneous transhepatic obliteration (PTO) is also one of the effective procedures for special types of bleeding varices, and we showed two cases with massive hemorrhage from the rectal varices, who were treated with PTO after a temporal hemostasis.…”

Section: Introductionmentioning

confidence: 93%

Percutaneous transhepatic obliteration for massive variceal rectal bleeding

et al. 2012

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“…Although several therapeutic approaches, including medical treatment, pleurodesis, continuous positive airway pressure [1], transjugular portosystemic shunt (TIPS) [2], and suturing via video-assisted thoracoscopic surgery (VATS) [3], have been attempted in these patients, the desired outcome (no recurrence) to date has been unsatisfactory. On the grounds that diaphragmatic defects play a role in those cases of HH in previous studies [4 -6], we investigated the effects of thoracoscopic pleural flap and mesh onlay reinforcement in a prospective trial involving refractory HH patients.…”

Section: Introductionmentioning

confidence: 99%

Thoracoscopic Diaphragmatic Repair for Refractory Hepatic Hydrothorax: Application of Pleural Flap and Mesh Onlay Reinforcement

Huang¹,

Kuo²,

Lee³

2006

Thorac cardiovasc Surg

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Transjugular intrahepatic portosystemic shunt: Experiences at a liver transplantation center

Abstract: In some liver transplant candidates, TIPS can be useful in minimizing the risk of complications of portal hypertension during the waiting time for a liver transplantation. TIPS can be monitored by Doppler US and revised if occlusion occurs.

Cited by 21 publications

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Transjugular intrahepatic portosystemic shunts: Experience in the oncology setting

Transjugular intrahepatic portosystemic shunts: Experience in the oncology setting

Percutaneous transhepatic obliteration for massive variceal rectal bleeding

Thoracoscopic Diaphragmatic Repair for Refractory Hepatic Hydrothorax: Application of Pleural Flap and Mesh Onlay Reinforcement

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