The Evolution of Transjugular Intrahepatic Portosystemic Shunt: Tips

Since Richter's description in the literature in 1989 of the first procedure on human patients, transjugular intrahepatic portosystemic shunt (TIPS) has been worldwide considered as a noninvasive technique to manage portal hypertension complications. TIPS succeeds in lowering the hepatic sinuso...

Full description

Bibliographic Details
Main Author:	Fanelli, Fabrizio
Format:	Online
Language:	English
Published:	Hindawi Publishing Corporation 2014
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4890882/

id	pubmed-4890882
recordtype	oai_dc
spelling	pubmed-48908822016-06-22 The Evolution of Transjugular Intrahepatic Portosystemic Shunt: Tips Fanelli, Fabrizio Review Article Since Richter's description in the literature in 1989 of the first procedure on human patients, transjugular intrahepatic portosystemic shunt (TIPS) has been worldwide considered as a noninvasive technique to manage portal hypertension complications. TIPS succeeds in lowering the hepatic sinusoidal pressure and in increasing the circulatory flow, thus reducing sodium retention, ascites recurrence, and variceal bleeding. Required several revisions of the shunt TIPS can be performed in case of different conditions such as hepatorenal syndrome, hepatichydrothorax, portal vein thrombosis, and Budd-Chiari syndrome. Most of the previous studies on TIPS procedure were based on the use of bare stents and most patients chose TIPS 2-3 years after traditional treatment, thus making TIPS appear to be not superior to endoscopy in survival rates. Bare stents were associated with higher incidence of shunt failure and consequently patients required several revisions during the follow-up. With the introduction of a dedicated e-PTFE covered stent-graft, these problems were completely solved, No more reinterventions are required with a tremendous improvement of patient's quality of life. One of the main drawbacks of the use of e-PTFE covered stent-graft is higher incidence of hepatic encephalopathy. In those cases refractory to the conventional medical therapy, a shunt reduction must be performed. Hindawi Publishing Corporation 2014-03-18 /pmc/articles/PMC4890882/ /pubmed/27335841 http://dx.doi.org/10.1155/2014/762096 Text en Copyright © 2014 Fabrizio Fanelli. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Fanelli, Fabrizio
spellingShingle	Fanelli, Fabrizio The Evolution of Transjugular Intrahepatic Portosystemic Shunt: Tips
author_facet	Fanelli, Fabrizio
author_sort	Fanelli, Fabrizio
title	The Evolution of Transjugular Intrahepatic Portosystemic Shunt: Tips
title_short	The Evolution of Transjugular Intrahepatic Portosystemic Shunt: Tips
title_full	The Evolution of Transjugular Intrahepatic Portosystemic Shunt: Tips
title_fullStr	The Evolution of Transjugular Intrahepatic Portosystemic Shunt: Tips
title_full_unstemmed	The Evolution of Transjugular Intrahepatic Portosystemic Shunt: Tips
title_sort	evolution of transjugular intrahepatic portosystemic shunt: tips
description	Since Richter's description in the literature in 1989 of the first procedure on human patients, transjugular intrahepatic portosystemic shunt (TIPS) has been worldwide considered as a noninvasive technique to manage portal hypertension complications. TIPS succeeds in lowering the hepatic sinusoidal pressure and in increasing the circulatory flow, thus reducing sodium retention, ascites recurrence, and variceal bleeding. Required several revisions of the shunt TIPS can be performed in case of different conditions such as hepatorenal syndrome, hepatichydrothorax, portal vein thrombosis, and Budd-Chiari syndrome. Most of the previous studies on TIPS procedure were based on the use of bare stents and most patients chose TIPS 2-3 years after traditional treatment, thus making TIPS appear to be not superior to endoscopy in survival rates. Bare stents were associated with higher incidence of shunt failure and consequently patients required several revisions during the follow-up. With the introduction of a dedicated e-PTFE covered stent-graft, these problems were completely solved, No more reinterventions are required with a tremendous improvement of patient's quality of life. One of the main drawbacks of the use of e-PTFE covered stent-graft is higher incidence of hepatic encephalopathy. In those cases refractory to the conventional medical therapy, a shunt reduction must be performed.
publisher	Hindawi Publishing Corporation
publishDate	2014
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4890882/
_version_	1613587961892306944

The Evolution of Transjugular Intrahepatic Portosystemic Shunt: Tips

Similar Items