Transjugular Intrahepatic Portosystemic Shunts in Pediatric Portal Hypertension: A Systematic Review and Meta-Analysis

Hermie, Laurens; Cauwenberghe, Lien Van; Dhondt, Elisabeth; Bruyne, Ruth De; Defreyne, Luc

doi:10.1016/j.jvir.2023.05.014

Cited by 3 publications

(3 citation statements)

References 81 publications

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“…42 In a recent meta-analysis by Hermie et al, 17 studies including a total of 284 patients with a mean weighted age of 10 years and a mean weighted follow-up of 3.6 years found that TIPS was technically successful in 93.3% of patients (95% confidence interval [CI], 88.5–97.1%), with an adverse event rate of 3.2% (95% CI, 0.7–6.9%) and an adjusted hepatic encephalopathy rate of 2.9% (95% CI, 0.6–6.3%). 43 The pooled 2-year primary and secondary patency rates were 61.8% (95% CI, 50.0–72.4%) and 99.8% (95% CI, 96.2–100.0%), respectively. Stent type ( p = 0.002) and patient age ( p = 0.04) were identified as significant sources of heterogeneity for clinical success.…”

Section: Managementmentioning

confidence: 96%

Section: Managementmentioning

confidence: 99%

“…The authors concluded that TIPS is a safe treatment for pediatric portal hypertension and that clinical outcomes, including long-term patency, can be improved with the use of covered stents. 43 In patients with chronic portal vein occlusion with cavernoma formation, recanalization of the portal vein plus TIPS (PVR TIPS) can be an excellent option when performed by experienced clinicians at a specialized tertiary care center. The use of this procedure may reduce the need for surgical portosystemic shunt creation.…”

Section: Endoscopic and Endovascular Interventional Managementmentioning

confidence: 99%

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Pathophysiology, Diagnosis, and Management of Portal Hypertension in the Pediatric Population

Karuvannur,

Laique,

Radhakrishnan

et al. 2024

Digestive Disease Interventions

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Portal hypertension is caused by resistance to the portal blood flow, which most commonly occurs in the setting of cirrhosis. Complications of portal hypertension can cause significant morbidity and mortality in the pediatric population. Portal hypertension is diagnosed when the hepatic venous pressure gradient (HVPG) is more than 5 mm Hg, and potential bleeding complications from esophageal and gastric varices are more likely when the HVPG is more than 10 mm Hg. Diagnosis can be made clinically; however, liver biopsy with measurement of the HVPG is ultimately required. The management of portal hypertension in pediatric patients is typically aimed at treatment of the complications. Despite the multiple pharmacologic, endoscopic, surgical, and interventional radiologic management techniques that are available, some pediatric patients will ultimately require liver transplant. Prompt referral is needed in such cases.

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Section: Managementmentioning

confidence: 96%

Section: Managementmentioning

confidence: 99%

Section: Endoscopic and Endovascular Interventional Managementmentioning

confidence: 99%

See 1 more Smart Citation

Pathophysiology, Diagnosis, and Management of Portal Hypertension in the Pediatric Population

Karuvannur,

Laique,

Radhakrishnan

et al. 2024

Digestive Disease Interventions

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Hepatobiliary Infection after Transjugular Intrahepatic Portosystemic Shunt Creation in Patients with Prior Biliary Intervention: A Multi-Institution Retrospective Study

Ronald,

Bartlett,

Border

et al. 2024

Journal of Vascular and Interventional Radiology

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French guidelines on TIPS: Indications and modalities

Larrue,

Allaire,

Weil‐Verhoeven

et al. 2024

Liver International

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Transjugular intrahepatic portosystemic shunt (TIPS) has become essential in the treatment or prevention of portal hypertension‐related complications. In the early 1990s, the primary indication was refractory bleeding. It is now proposed for the treatment of ascites for the prevention of bleeding and in patients with vascular diseases of the liver. Thus, there are a growing number of patients being treated with TIPS all over the world. The broadening of indications, the involvement of multiple stakeholders, the need for an accurate selection, the positioning in relation to transplantation and the lack of standardization in pre‐therapeutic assessment, in the procedure itself and in the follow‐up have led the board of the French Association for the Study of the Liver to establish recommendations.

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Transjugular Intrahepatic Portosystemic Shunts in Pediatric Portal Hypertension: A Systematic Review and Meta-Analysis

Cited by 3 publications

References 81 publications

Pathophysiology, Diagnosis, and Management of Portal Hypertension in the Pediatric Population

Pathophysiology, Diagnosis, and Management of Portal Hypertension in the Pediatric Population

Hepatobiliary Infection after Transjugular Intrahepatic Portosystemic Shunt Creation in Patients with Prior Biliary Intervention: A Multi-Institution Retrospective Study

French guidelines on TIPS: Indications and modalities

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