Abstract：
:Transjugular intrahepatic portosystemic shunt (TIPS) represents a very effective treatment of complications of portal hypertension. Established indications to TIPS in cirrhotic patients include portal hypertensive bleeding and refractory ascites. Over the years additional indications have been proposed, such as the treatment of vascular disease of the liver, hepatic hydrothorax, hepatorenal syndrome and bleeding from ectopic varices. Indications under evaluation include treatment of portal hypertension prior to major abdominal surgery and treatment of portal vein thrombosis. In spite of these advances, there are still uncertainties regarding the appropriate workup for patients to be scheduled for TIPS. Moreover, prevention and management of post-TIPS complications including hepatic encephalopathy and heart failure are still suboptimal. These issues are particularly relevant considering aging in TIPS candidates in Western countries. Correct selection of patients is mandatory to prevent complications which may eventually frustrate the good hemodynamic results and worsen the patient's quality of life or even life expectancy. The possible role of small diameter TIPS to prevent post-procedural complications is discussed.
journal_name
Intern Emerg Medjournal_title
Internal and emergency medicineauthors
Vizzutti F,Schepis F,Arena U,Fanelli F,Gitto S,Aspite S,Turco L,Dragoni G,Laffi G,Marra Fdoi
10.1007/s11739-019-02252-8subject
Has Abstractpub_date
2020-01-01 00:00:00pages
37-48issue
1eissn
1828-0447issn
1970-9366pii
10.1007/s11739-019-02252-8journal_volume
15pub_type
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