Transjugular intrahepatic portosystemic shunt placement in patients with cirrhosis and concomitant portal vein thrombosis.

Abstract:

PURPOSE:To determine the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) creation in patients with liver cirrhosis complicated by thrombosed portal vein. METHODS:This study reviewed 15 cases of TIPS creation in 15 cirrhotic patients with portal vein thrombosis at our institution over an 8-year period. There were 2 women and 13 men with a mean age of 53 years. Indications were refractory ascites, variceal hemorrhage, and refractory pleural effusion. Clinical follow-up was performed in all patients. RESULTS:The technical success rate was 75% (3/4) in patients with chronic portal vein thrombosis associated with cavernomatous transformation and 91% (10/11) in patients with acute thrombosis or partial thrombosis, giving an overall success rate of 87%. Complications included postprocedural encephalopathy and localized hematoma at the access site. In patients with successful shunt placement, the total follow-up time was 223 months. The 30-day mortality rate was 13%. Two patients underwent liver transplantation at 35 days and 7 months, respectively, after TIPS insertion. One patient had an occluded shunt at 4 months with an unsuccessful revision. The remaining patients had functioning shunts at follow-up. CONCLUSION:TIPS creation in thrombosed portal vein is possible and might be a treatment option in certain patients.

authors

Van Ha TG,Hodge J,Funaki B,Lorenz J,Rosenblum J,Straus C,Leef J

doi

10.1007/s00270-005-0090-4

subject

Has Abstract

pub_date

2006-09-01 00:00:00

pages

785-90

issue

5

eissn

0174-1551

issn

1432-086X

journal_volume

29

pub_type

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