Transjugular intrahepatic portosystemic shunt with expanded-polytetrafuoroethylene-covered stents in non-cirrhotic patients with portal cavernoma

Fanelli, Fabrizio; Angeloni, S.; Salvatori, Filippo Maria; Marzano, C.; Boatta, Emanuele; Merli, Manuela; Rossi, Plinio; Attili, Adolfo Francesco; Ridola, Lorenzo; Cerini, Federica; Riggio, Oliviero

doi:10.1016/j.dld.2010.06.001

Cited by 79 publications

(72 citation statements)

References 40 publications

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“…In other available studies, heterogeneous cases with and without liver cirrhosis and with and without portal cavernoma are included (Table 4) [10][11][12][13][14][15]. In the study by Fanelli et al, TIPS was successfully created in 92% (11/12) of patients [9]. By comparison, TIPS success rate appeared to be lower (35%, 7/20) in our study.…”

Section: Discussioncontrasting

confidence: 68%

“…These conditions promote us to conduct the present study aimed at evaluating the feasibility, safety, and efficacy of TIPS for the treatment of symptomatic portal hypertension in non-cirrhotic patients with portal cavernoma. Our study suggested the following: (1) TIPS creation by combination with a transhepatic or transsplenic approach was feasible and safe in the presence of portal cavernoma, but TIPS was not recommended in the patients with a total fibrotic cord and without a large collateral vein or in those with extensive superior mesenteric vein thrombosis; (2) successful TIPS insertions could decrease the portosystemic pressure gradient and the incidence of variceal rebleeding; and (3) the Until now, only one case series has focused on assessing the outcome of TIPS in non-cirrhotic patients with portal cavernoma [9]. In other available studies, heterogeneous cases with and without liver cirrhosis and with and without portal cavernoma are included (Table 4) [10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 97%

“…However, the presence of portal cavernoma is regarded as a contraindication to TIPS due to the technical difficulty and potential procedure-related complications [7,8]. Additionally, given the rarity of this disease in the absence of liver cirrhosis and malignancy, the experiences on the applications of TIPS procedure are very limited in a few case reports and series [9][10][11][12][13][14][15]. Herein, we reported the results of a single-center case series to evaluate the feasibility, safety, and efficacy of TIPS for the treatment of symptomatic portal hypertension in noncirrhotic patients with portal cavernoma.…”

Section: Introductionmentioning

confidence: 97%

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Transjugular Intrahepatic Portosystemic Shunt for Portal Cavernoma with Symptomatic Portal Hypertension in Non-cirrhotic Patients

Han

Yin

et al. 2011

Dig Dis Sci

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Section: Discussioncontrasting

confidence: 68%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 97%

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Transjugular Intrahepatic Portosystemic Shunt for Portal Cavernoma with Symptomatic Portal Hypertension in Non-cirrhotic Patients

Han

Yin

et al. 2011

Dig Dis Sci

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“…167 In chronic PVT (portal cavernoma) TIPS placement has been successful in 35%-80%. [168][169][170][171] TIPS is unsuccessful if the lumen of thrombosed portal vein is not catheterizable and cavernomatous vein is not amenable to dilatation.…”

Section: Tipsmentioning

confidence: 99%

Portal Vein Thrombosis

Chawla

Bodh

2015

Journal of Clinical and Experimental Hepatology

151

147

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Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. ( J CLIN EXP HEPATOL 2015;5:22-40)

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“…TIPS have been performed in patients with PVT at different severity, mostly non cirrhotic and even in presence of cavernomatous transformation of the portal vein [9,11,20,173] (Supplementary material-Appendix 3). The patency of intra-hepatic portal veins branches and partial thrombosis of the main trunk are positive prognostic factors for technical success [182]. The thrombotic occlusion of the intrahepatic portal vein branches compels the use of transcutaneous approach which bears an increased risk of complications [183,184].…”

Section: Votation 43 Votes In Favour 100%mentioning

confidence: 99%

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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Transjugular intrahepatic portosystemic shunt with expanded-polytetrafuoroethylene-covered stents in non-cirrhotic patients with portal cavernoma

Cited by 79 publications

References 40 publications

Transjugular Intrahepatic Portosystemic Shunt for Portal Cavernoma with Symptomatic Portal Hypertension in Non-cirrhotic Patients

Transjugular Intrahepatic Portosystemic Shunt for Portal Cavernoma with Symptomatic Portal Hypertension in Non-cirrhotic Patients

Portal Vein Thrombosis

Consensus conference on TIPS management: Techniques, indications, contraindications

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