Portal Hypertensive Biliopathy in Adult Patients: Findings and Interventional Radiologic Treatment—A Single-Center Experience

2019 ◽  
Vol 39 (04) ◽  
pp. 502-512 ◽  
Author(s):  
Alberta Cappelli ◽  
Francesco Modestino ◽  
Cristina Mosconi ◽  
Caterina De Benedittis ◽  
Antonio Bruno ◽  
...  
Keyword(s):  
Portosystemic Shunt ◽  
Clinical Scenario ◽  
First Line ◽  
Portal Vein Occlusion ◽  
Single Center Experience ◽  
Vein Occlusion ◽  
Life Threatening ◽  
Intrahepatic Portosystemic Shunt ◽  
First Line Treatment ◽  
Morphologic Appearance

AbstractThe aim of this study was to evaluate the morphologic appearance, the clinical scenario, and the outcomes of patients with portal hypertensive biliopathy (PHB), particularly in the symptomatic subgroup treated with interventional radiology (IR) procedures. The outcome of 20 patients with PHB were retrospectively reviewed over a 5-year period. In all cases, the extrahepatic portal vein occlusion (EHPVO) and the compensatory cavernomatosis was the cause of PHB. Eight out of 20 patients had severe symptoms (jaundice and bleeding). Five out of these eight patients were successfully treated with IR procedures. PHB is a rare but serious complication of PH from EHPVO. IR treatments are highly effective in controlling symptoms. Moreover, IR procedures, as drainage and transjugular intrahepatic portosystemic shunt placement, are the first-line treatment in cases of life-threatening bleeding from ruptures of the varices.

Transjugular intrahepatic portosystemic shunt in a patient with cavernomatous portal vein occlusion

2000 ◽  
Vol 23 (2) ◽  
pp. 145-149 ◽  
Author(s):  
Hiroshi Kawamata ◽  
Tatsuo Kumazaki ◽  
Hidenori Kanazawa ◽  
Shuji Takahashi ◽  
Hiroyuki Tajima ◽  
...  
Keyword(s):  
Portal Vein ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Portosystemic Shunt ◽  
Portal Vein Occlusion ◽  
Vein Occlusion ◽  
Intrahepatic Portosystemic Shunt

Percutaneous transhepatic intrahepatic portosystemic shunt for variceal bleeding with chronic portal vein occlusion after splenectomy

2018 ◽  
Vol 28 (9) ◽  
pp. 3661-3668 ◽  
Author(s):  
Junyang Luo ◽  
Mingan Li ◽  
Youyong Zhang ◽  
Haofan Wang ◽  
Mingsheng Huang ◽  
...  
Keyword(s):  
Portal Vein ◽  
Variceal Bleeding ◽  
Portosystemic Shunt ◽  
Portal Vein Occlusion ◽  
Vein Occlusion ◽  
Intrahepatic Portosystemic Shunt

Treatment of acute portomesenteric venous thrombosis with thrombectomy through a transjugular intrahepatic portosystemic shunt: a single-center experience

2017 ◽  
Vol 59 (8) ◽  
pp. 953-958 ◽  
Author(s):  
Kerstin Rosenqvist ◽  
Charlotte Ebeling Barbier ◽  
Fredrik Rorsman ◽  
Per Sangfelt ◽  
Rickard Nyman
Keyword(s):  
Venous Thrombosis ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Symptom Relief ◽  
Portosystemic Shunt ◽  
Single Center Experience ◽  
Threatening Condition ◽  
Life Threatening ◽  
Intrahepatic Portosystemic Shunt ◽  
Portomesenteric Venous Thrombosis ◽  
Age Range

Background Acute portomesenteric venous thrombosis (PMVT) is a potentially life-threatening condition and urgent treatment is required. Purpose To retrospectively evaluate the efficacy and safety of treating acute PMVT by the creation of a transjugular intrahepatic portosystemic shunt (TIPS) followed by thrombectomy. Material and Methods Six patients (all men, age range = 39–51 years) presenting with acute PMVT were treated with transjugular thrombectomy (TT) through a TIPS created in the same session. The intervention included iterated venography through the TIPS one to three times within the first week after diagnosis and repeated thrombectomy if needed (n = 5). Results Recanalization was successful with persistent blood flow through the main superior mesenteric vein, portal vein, and TIPS in all six patients. Five patients were treated primarily with thrombectomy through a TIPS with clinical improvement. The final patient was initially treated with surgical thrombectomy and bowel resection. TIPS and TT was performed two days after surgery due to re-thrombosis but the patient deteriorated and died of multi-organ failure. Procedure-related complications were transient hematuria (n = 3) and transient encephalopathy (n = 2). In-hospital time was <14 days in four of the five patients with primary TIPS and TT. No sign of re-thrombosis was noted during follow-up (mean = 18 months, range = 8–28 months). Conclusion Thrombectomy through a TIPS is feasible and can be effective in recanalization and symptom-relief in acute PMVT.

Pediatric Transjugular Intrahepatic Portosystemic Shunts

2017 ◽  
Vol 01 (04) ◽  
pp. 277-285 ◽  
Author(s):  
David Shin ◽  
Giridhar Shivaram ◽  
Kevin Koo ◽  
Eric Monroe
Keyword(s):  
Portal Hypertension ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Portosystemic Shunt ◽  
Portal Vein Occlusion ◽  
Vein Occlusion ◽  
Portosystemic Shunts ◽  
Portal Decompression ◽  
Life Saving ◽  
Intrahepatic Portosystemic Shunt

AbstractTransjugular intrahepatic portosystemic shunt (TIPS) creation offers potentially life-saving portal decompression regardless of patient age or size, but has been underutilized in pediatric patients to date. Experience has therefore been limited, and the full clinical benefit in this population is yet to be realized. Those wishing to embark on pediatric TIPSs would benefit not only from significant experience in adult TIPSs, but also from an awareness of challenges posed by the unique pediatric population. We herein review the etiologies and manifestations of portal hypertension more common in children, highlight some of the technical nuances of creating TIPSs in smaller anatomy, and summarize the existing literature on the topic. As extrahepatic portal vein occlusion (EHPVO) occurs with greater frequency in pediatric patients, special attention is paid to this condition and its associated challenges.

Transjugular Intrahepatic Portosystemic Shunt in patients after orthotopic liver transplantation (OLTx) due to life threatening gastrointestinal hemorrhage. A single-center experience based on three cases and literature review

2018 ◽  
Vol 91 (2) ◽  
pp. 38-44
Author(s):  
Magdalena Januszewicz ◽  
Inga Włodarczyk-Pruszyńska ◽  
Krzysztof Milczarek ◽  
Katarzyna Rowińska-Berman ◽  
Krzysztof Zieniewicz ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Portosystemic Shunt ◽  
Liver Graft ◽  
Shunt System ◽  
Single Center Experience ◽  
Life Saving ◽  
Chiari Syndrome ◽  
Life Threatening ◽  
Intrahepatic Portosystemic Shunt

Background: Transjugular intrahepatic portosystemic shunt system (TIPS) is a well-recognized method of treatment of symptomatic portal hypertension in patients awaiting liver transplantation. Effectiveness of the TIPS treatment in patients after liver transplantation is still not fully established. Indications for both groups of patients, with and without liver graft, are similar and include bleeding from gastrointestinal varices, ascites, pleural effusion and Budd-Chiari syndrome. Feasibility of TIPS in emergency treatment in patients after OLTx due to life threatening hemorrhage is not well described. Materials and methods: Patients after OLTx performed using classical, non piggy-back technique had severe hemorrhages from gastrointestinal varices due to loss of grafts function. Patients were in an unstable condition, required blood transfusions on admittance and monitoring in Intensive Care Unit. TIPS were implanted urgently, after unsuccessful endoscopic treatment, as a life-saving procedure. Results: In all cases procedure was successfully completed. The bleeding did not reoccur during postoperative course. Conclusion: TIPS procedure appears to be justified, as a bridge to a planned retransplantation, or as a treatment of choice in patients disqualified from re-transplantation. Emergency performance of the TIPS procedure, as a treatment for acute variceal bleeding should still be considered individually for each patient and only as a procedure leading to further treatment.

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