The transjugular intrahepatic portosystemic stent-shunt: a review of the literature and own experiences.

Abstract:

:The transjugular intrahepatic portosystemic stent-shunt (TIPS) technique consists of a transhepatic puncture of the portal vein and stenting of the parenchymal tract between the hepatic and portal veins. Complications of both puncture and stenting are observed in approximately 5% of procedures. Most of the complications are without clinical consequences and the procedural mortality is very low in experienced hands (1%). During a 1 year follow up, 35% of patients were seen to develop stenosis and 15% developed occlusion of the stent-shunt. However, in spite of the considerable incidence of stenosis/occlusion, the rate of variceal rebleeding is rare when patients are followed up carefully by duplex sonography, which allows accurate and early detection of shunt insufficiency. One of the major long-term clinical problems of TIPS is the induction or worsening of hepatic encephalopathy. Although most patients respond to medical treatment, some develop debilitating encephalopathy or progressive liver failure. In these patients, reduction of shunt flow by the implantation of a reducing stent, or its occlusion with a balloon catheter, may be indicated. In conclusion, in spite of many complications, TIPS is relatively safe and efficient and hepatic encephalopathy is manageable in most cases.

authors

Rössle M,Haag K,Blum HE

doi

10.1111/j.1440-1746.1996.tb00079.x

subject

Has Abstract

pub_date

1996-03-01 00:00:00

pages

293-8

issue

3

eissn

0815-9319

issn

1440-1746

journal_volume

11

pub_type

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