TIPS vs. endoscopic treatment for prevention of recurrent variceal bleeding: a long-term follow-up of 126 patients

Abstract Background Recurrent bleeding from gastroesophageal varices is the most common life-threatening complication of portal hypertension. According to guidelines, transjugular intrahepatic portosystemic shunt (TIPS) should not be used as a first-line treatment and should be limited to those bleedings which are refractory to pharmacologic and endoscopic treatment (ET). To our knowledge, long-term studies evaluating the role of elective TIPS in comparison to ET in patients with recurrent variceal bleeding episodes are rare. Patients and methods This study was designed as a retrospective single-institution analysis of 70 patients treated with TIPS and 56 with ET. Patients were followed-up from inclusion in the study until death, liver transplantation, the last follow-up observation or until the end of our study. Results Recurrent variceal bleeding was significantly more frequent in ET group compared to patients TIPS group (66.1% vs. 21.4%, p < 0.001; χ2-test). The incidence of death secondary to recurrent bleeding was higher in the ET group (28.6% vs. 10%). Cumulative survival after 1 year, 2 years and 5 years in TIPS group compared to ET group was 85% vs. 83%, 73% vs. 67% and 41% vs. 35%, respectively. The main cause of death in patients with cumulative survival more than 2 years was liver failure. Median observation time was 47 months (range; 2–194 months) in the TIPS group and 40 months (range; 1–168 months) in the ET group. Conclusions In present study TIPS was more effective in the prevention of recurrent variceal bleeding and had lower mortality due to recurrent variceal bleeding compared to ET.

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Endoscopic treatment of esophagogastric variceal bleeding in patients with noncirrhotic extrahepatic portal vein thrombosis: a long-term follow-up study

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2007.08.023 ◽

2008 ◽

Vol 67 (6) ◽

pp. 821-827 ◽

Cited By ~ 36

Author(s):

Manon C.W. Spaander ◽

Sarwa Darwish Murad ◽

Henk R. van Buuren ◽

Bettina E. Hansen ◽

Ernst J. Kuipers ◽

...

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Variceal Bleeding ◽

Endoscopic Treatment ◽

Vein Thrombosis ◽

Follow Up Study ◽

Long Term Follow Up

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Long-term follow-up results of medial opening wedge high tibia osteotomy with a pre-countered non-locking steel plate

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-03927-8 ◽

2021 ◽

Author(s):

Simo S. A. Miettinen ◽

Hannu J. A. Miettinen ◽

Jussi Jalkanen ◽

Antti Joukainen ◽

Heikki Kröger

Keyword(s):

Risk Factors ◽

Adverse Events ◽

Mechanical Axis ◽

Steel Plate ◽

Cox Regression ◽

Opening Wedge ◽

Cumulative Survival ◽

Long Term Follow Up

Abstract Introduction This retrospective study investigated the long-term follow-up results of medial opening wedge high tibial osteotomy (MOWHTO) with a pre-countered non-locking steel plate implant (Puddu plate = PP) used for medial knee osteoarthrosis (OA) treatment. Materials and methods Consecutive 70 MOWHTOs (66 patients) were performed between 01.01.2004 and 31.12.2008 with the mean follow-up time of 11.4 (SD 4.5; range 1.2–16.1) years. The Kaplan–Meier survival analysis was used to evaluate the cumulative survival of the implant in terms of age (< 50 years old and ≥ 50 years old) and gender. Adverse events were studied and Cox regression analysis was used to evaluate risk factors [age, gender, body mass index (BMI), preoperative mechanical axis, severity of OA, use of bone grafting or substitution and undercorrection of mechanical axis from varus to valgus] for revisions. Results The estimates for the cumulative survival with no need for TKA after MOWHTO were 86% at 5 years, 67% at 10 years and 58% at 16.1 years (SE 0.6, CI 95% 11.1–13.5). A total of 33/70 (47%) adverse events occurred and 38/70 (54%) knees required some revision surgery during the follow-up. Cox regression did not show any statistically significant risk factors for revision. Conclusions The PP has feasible MOWHTO results with a cumulative survival of 67% at 10 years with no need for conversion to TKA. Many adverse events occurred and revision rate due to any reason was high. Age or gender did not have statistically significant differences in terms of survival.

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VESCICO-URETERAL REFLUX: ENDOSCOPIC TREATMENT, MANAGEMENT AND LONG-TERM FOLLOW-UP

Journal of the Siena Academy of Sciences ◽

10.4081/jsas.2010.44 ◽

2012 ◽

Vol 2 (1) ◽

pp. 44

Author(s):

A.L Bulotta ◽

G. Di Maggio ◽

A. Garzi ◽

R. Angotti ◽

E. Cerchia ◽

...

Keyword(s):

Endoscopic Treatment ◽

Treatment Management ◽

Long Term Follow Up

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Aorto-esophageal fistula: successful open surgical management of two cases

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa114 ◽

2020 ◽

Vol 2020 (6) ◽

Author(s):

Siddharth Pahwa ◽

Susmit Bhattacharya ◽

Siddhartha Mukhopadhyay ◽

Ashok Verma

Keyword(s):

Surgical Management ◽

Surgical Repair ◽

Hemodynamic Instability ◽

Esophageal Fistula ◽

Long Term Follow Up ◽

Life Threatening ◽

Dacron Patch ◽

Upper Gastrointestinal

Abstract An aorto-esophageal fistula (AEF) is a rare yet life-threatening cause of upper gastrointestinal bleeding. We report our experience with open surgical management of two cases of AEF. Both cases presented with almost identical presentations: hematemesis and hemodynamic instability. The aorta in the first patient was normal; the defect was small and was repaired with a Dacron patch. The second patient had an aneurysmal aorta, which was replaced with a Dacron graft. Both cases were performed under partial bypass. The esophageal rent in both patients was debrided, primarily closed and buttressed with a vascularized intercostal pedicle. Nonavailability of endovascular personnel and equipment along with hemodynamic instability of the patient influenced our surgical strategy. Long-term follow-up of these patients is necessary to analyze the outcomes of our surgical repair.

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Coronaric Stent-Graft Deployment in the Treatment of Carotid Blowout

Interventional Neuroradiology ◽

10.1177/159101991101700416 ◽

2011 ◽

Vol 17 (4) ◽

pp. 490-494 ◽

Cited By ~ 5

Author(s):

E. Pampana ◽

R. Gandini ◽

M. Stefanini ◽

S. Fabiano ◽

A. Chiaravalloti ◽

...

Keyword(s):

Stent Graft ◽

Clinical Results ◽

Covered Stent ◽

Endovascular Stent Graft ◽

Carotid Blowout Syndrome ◽

Rescue Treatment ◽

Long Term Follow Up ◽

Life Threatening

“Carotid blowout syndrome” is defined as a hemorrhage caused by rupture of the carotid artery and its branches, and may be a severe complication of rhinopharyngeal carcinoma. This study aimed to highlight the usefulness and versatility of endovascular stent-graft placement as a rescue treatment in life-threatening carotid blowout syndrome. We describe the unconventional use of a 6×5 mm balloon-expandable coronaric covered stent in a patient with a diagnosis of spinocellular rhinopharyngeal carcinoma, followed by carotid blowout syndrome. Although long-term follow-up is needed to assess the eventuality of bleeding recurrence, the immediate clinical results were satisfactory.

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