PURPOSE: The authors present a retrospective analysis of a large series of patients who underwent transjugular intrahepatic portosystemic shunt (TIPS) placement. MATERIALS AND METHODS: Between March 1992 and December 2006, 658 patients were referred to our centre for TIPS placement. Indications for the procedure were digestive tract bleeding (52.8%), refractory ascites (35.3%), preservation of portal vein patency prior to liver transplantation (3.0%) and thrombosis of the suprahepatic veins (2.3%). Other indications (6.6%) included pleural ascites, portal thrombosis and hepatorenal and hepatopulmonary syndromes. All patients were evaluated with colour Doppler ultrasonography and in a few cases with computed tomography. The portal system was punctured under sonographic guidance. Wallstent, Palmaz and Nitinol thermosensitive stents were used. Embolisation of persistent varices was performed in 6.8% of cases. RESULTS: Technical success was 98.9%. During a 1,500-day follow-up, the cumulative incidence of stent revision was 25.7% (Nitinol), 32.9% (Wallstent) and 1.8% (Palmaz). Mortality rates were 31.1%, 38.5% and 56.4%, respectively. The technical complications included six cases of heart failure, six of haematobilia, three of stent migration, two of intrahepatic haematoma and one of haemoperitoneum. Eight patients with severe portosystemic encephalopathy (PSE) were treated with a reduction stent. CONCLUSIONS: TIPS placement is safe and effective and may act as a bridge to liver transplantation. Ultrasonography plays a fundamental role in the preliminary assessment, in portal vein puncture and during the follow-up. Stent patency is satisfactory.
PURPOSE: The authors present a retrospective analysis of a large series of patients who underwent transjugular intrahepatic portosystemic shunt (TIPS) placement. MATERIALS AND METHODS: Between March 1992 and December 2006, 658 patients were referred to our centre for TIPS placement. Indications for the procedure were digestive tract bleeding (52.8%), refractory ascites (35.3%), preservation of portal vein patency prior to liver transplantation (3.0%) and thrombosis of the suprahepatic veins (2.3%). Other indications (6.6%) included pleural ascites, portal thrombosis and hepatorenal and hepatopulmonary syndromes. All patients were evaluated with colour Doppler ultrasonography and in a few cases with computed tomography. The portal system was punctured under sonographic guidance. Wallstent, Palmaz and Nitinol thermosensitive stents were used. Embolisation of persistent varices was performed in 6.8% of cases. RESULTS: Technical success was 98.9%. During a 1,500-day follow-up, the cumulative incidence of stent revision was 25.7% (Nitinol), 32.9% (Wallstent) and 1.8% (Palmaz). Mortality rates were 31.1%, 38.5% and 56.4%, respectively. The technical complications included six cases of heart failure, six of haematobilia, three of stent migration, two of intrahepatic haematoma and one of haemoperitoneum. Eight patients with severe portosystemic encephalopathy (PSE) were treated with a reduction stent. CONCLUSIONS: TIPS placement is safe and effective and may act as a bridge to liver transplantation. Ultrasonography plays a fundamental role in the preliminary assessment, in portal vein puncture and during the follow-up. Stent patency is satisfactory.
Authors: D Azoulay; F Buabse; I Damiano; A Smail; P Ichai; M Dannaoui; D Castaing; H Bismuth Journal: J Am Coll Surg Date: 2001-07 Impact factor: 6.113
Authors: Wael E A Saad; Nael E A Saad; Mark G Davies; Adel Bozorgdadeh; Mark S Orloff; Nikhil C Patel; Peter L Abt; David E Lee; Lawrence G Sahler; Takashi Kitanosono; Talia Sasson; David L Waldman Journal: J Vasc Interv Radiol Date: 2006-06 Impact factor: 3.464
Authors: Ramasamy Saravanan; Manu Nayar; Ian T Gilmore; Howard Smart; Richard G McWilliams; Peter C Rowlands; Jonathan Evans; Mike Murphy; Derek Gould; Steve Taylor; Robert Sutton; Martin G Lombard Journal: Eur J Gastroenterol Hepatol Date: 2005-11 Impact factor: 2.566
Authors: C Gazzera; P Fonio; C Gallesio; F Camerano; A Doriguzzi Breatta; D Righi; A Veltri; G Gandini Journal: Radiol Med Date: 2012-06-28 Impact factor: 3.469
Authors: Paolo Fonio; Andrea Discalzi; Marco Calandri; Andrea Doriguzzi Breatta; Laura Bergamasco; Silvia Martini; Antonio Ottobrelli; Dorico Righi; Giovanni Gandini Journal: Radiol Med Date: 2017-05-16 Impact factor: 3.469