Comparison of the Covered Self-Expandable Viatorr CX Stent with the Covered Balloon-Expandable BeGraft Peripheral Stent for Transjugular Intrahepatic Portosystemic Shunt (TIPS) Creation: a Single-Centre Retrospective Study in Patients with Variceal Bleeding

2022 ◽  
Author(s):  
Michael Schultheiss ◽  
Dominik Bettinger ◽  
Lukas Sturm ◽  
Arthur Schmidt ◽  
Johanna Backhus ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Variceal Bleeding ◽  
Portosystemic Shunt ◽  
Single Centre ◽  
Intrahepatic Portosystemic Shunt

scholarly journals Glue Embolization of Gastroesophageal Varices during Transjugular Intrahepatic Portosystemic Shunt (TIPS) Improves Survival Compared to Coil-only Embolization—A Single-Center Retrospective Study

2021 ◽  
Author(s):  
Karsten Wolter ◽  
Michael Praktiknjo ◽  
Julia Boie ◽  
Georges Decker ◽  
Jennifer Nadal ◽  
...  
Keyword(s):  
Overall Survival ◽  
Retrospective Study ◽  
Treatment Failure ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Portosystemic Shunt ◽  
Refractory Ascites ◽  
Secondary Outcome ◽  
Gastroesophageal Varices ◽  
Intrahepatic Portosystemic Shunt ◽  
Glue Embolization

Abstract Purpose To compare the safety and effectiveness of coil versus glue embolization of gastroesophageal varices during transjugular intrahepatic portosystemic shunt (TIPS) creation. Materials and Methods In this monocentric retrospective study 104 (males: 67 (64%)) patients receiving TIPS with concomitant embolization of GEV and a minimum follow-up of one year (2008—2017) were included. Primary outcome parameter was overall survival (6 week; 1 year). Six-week overall survival was assessed as a surrogate for treatment failure as proposed by the international Baveno working group. Secondary outcome parameters were development of acute-on-chronic liver failure (ACLF), variceal rebleeding and hepatic encephalopathy (HE). Survival analysis was performed using Kaplan–Meier with log-rank test and adjusted Cox regression analysis. Results Indications for TIPS were refractory ascites (n = 33) or variceal bleeding (n = 71). Embolization was performed using glue with or without coils (n = 40) (Group G) or coil-only (n = 64) (Group NG). Overall survival was significantly better in group G (p = 0.022; HR = -3.333). Six-week survival was significantly lower in group NG (p = 0.014; HR = 6.945). Rates of development of ACLF were significantly higher in group NG after 6 months (NG = 14; G = 6; p = 0.039; HR = 3.243). Rebleeding rates (NG = 6; G = 3; p = 0.74) and development of HE (NG = 22; G = 15; p = 0.75) did not differ significantly between groups. Conclusion Usage of glue in embolization of GEV may improve overall survival, reduce treatment failure and may be preferable over coil embolization alone.

Transjugular Intrahepatic Portosystemic Shunt Placement for Variceal Bleeding: Predictors of Mortality

1995 ◽  
Vol 6 (5) ◽  
pp. 687-694 ◽  
Author(s):  
Carlos E. Encarnacion ◽  
Julio C. Palmaz ◽  
Frank J. Rivera ◽  
Oscar A. Alvarez ◽  
Kedar N. Chintapalli ◽  
...  
Keyword(s):  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Variceal Bleeding ◽  
Portosystemic Shunt ◽  
Predictors Of Mortality ◽  
Shunt Placement ◽  
Intrahepatic Portosystemic Shunt

TIPS: a new alternative for the variceal bleeder

1993 ◽  
Vol 2 (3) ◽  
pp. 196-201 ◽  
Author(s):  
L Adams ◽  
MC Soulen
Keyword(s):  
Portal Hypertension ◽  
Hepatic Vein ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Variceal Bleeding ◽  
Balloon Catheter ◽  
Portosystemic Shunt ◽  
Recurrent Bleeding ◽  
Secondary Patency ◽  
Secondary Patency Rate ◽  
Intrahepatic Portosystemic Shunt

BACKGROUND: Standard medical therapies for variceal bleeding secondary to portal hypertension (vasopressin, esophagogastric balloon tamponade and sclerotherapy) are associated with high rates of recurrent bleeding. Surgical shunting has a mortality rate of 15% to 50%. The transjugular intrahepatic portosystemic shunt offers a novel, minimally invasive procedure for nonsurgical portal decompression. METHOD: Following catheterization of the hepatic vein from a jugular vein approach, a needle is directed fluoroscopically from the hepatic vein into a branch of the portal vein along an intrahepatic tract. The intrahepatic tract is then dilated and held open with a stainless steel stent delivered on a balloon catheter. This creates a portosystemic shunt entirely within the liver. RESULTS: The collective experience of more than 300 cases from several centers has been reported. The technical success rate for the transjugular intrahepatic portosystemic shunt is 92% to 96%. Thirty-day mortality rates range from 0% to 14%, with less than 3% attributed to procedural complications. Primary shunt patency is about 90%, with a secondary patency rate of 100%. Rates of encephalopathy and rebleeding are 9% to 14%. Ascites resolves in 80% to 90% of patients. CONCLUSION: The transjugular intrahepatic portosystemic shunt appears to be a safe and effective procedure for management of variceal bleeding and holds promise for becoming the treatment of choice for portal hypertension.

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