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The Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Portal Hypertension: Current Status
The transjugular intrahepatic portosystemic shunt (TIPS) represents a major advance in the treatment of complications of portal hypertension. Technical improvements and increased experience over the past 24 years led to improved clinical results and a better definition of the indications for TIPS. R...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408669/ https://www.ncbi.nlm.nih.gov/pubmed/22888442 http://dx.doi.org/10.1155/2012/167868 |
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author | Pomier-Layrargues, Gilles Bouchard, Louis Lafortune, Michel Bissonnette, Julien Guérette, Dave Perreault, Pierre |
author_facet | Pomier-Layrargues, Gilles Bouchard, Louis Lafortune, Michel Bissonnette, Julien Guérette, Dave Perreault, Pierre |
author_sort | Pomier-Layrargues, Gilles |
collection | PubMed |
description | The transjugular intrahepatic portosystemic shunt (TIPS) represents a major advance in the treatment of complications of portal hypertension. Technical improvements and increased experience over the past 24 years led to improved clinical results and a better definition of the indications for TIPS. Randomized clinical trials indicate that the TIPS procedure is not a first-line therapy for variceal bleeding, but can be used when medical treatment fails, both in the acute situation or to prevent variceal rebleeding. The role of TIPS to treat refractory ascites is probably more justified to improve the quality of life rather than to improve survival, except for patients with preserved liver function. It can be helpful for hepatic hydrothorax and can reverse hepatorenal syndrome in selected cases. It is a good treatment for Budd Chiari syndrome uncontrollable by medical treatment. Careful selection of patients is mandatory before TIPS, and clinical followup is essential to detect and treat complications that may result from TIPS stenosis (which can be prevented by using covered stents) and chronic encephalopathy (which may in severe cases justify reduction or occlusion of the shunt). A multidisciplinary approach, including the resources for liver transplantation, is always required to treat these patients. |
format | Online Article Text |
id | pubmed-3408669 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-34086692012-08-10 The Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Portal Hypertension: Current Status Pomier-Layrargues, Gilles Bouchard, Louis Lafortune, Michel Bissonnette, Julien Guérette, Dave Perreault, Pierre Int J Hepatol Review Article The transjugular intrahepatic portosystemic shunt (TIPS) represents a major advance in the treatment of complications of portal hypertension. Technical improvements and increased experience over the past 24 years led to improved clinical results and a better definition of the indications for TIPS. Randomized clinical trials indicate that the TIPS procedure is not a first-line therapy for variceal bleeding, but can be used when medical treatment fails, both in the acute situation or to prevent variceal rebleeding. The role of TIPS to treat refractory ascites is probably more justified to improve the quality of life rather than to improve survival, except for patients with preserved liver function. It can be helpful for hepatic hydrothorax and can reverse hepatorenal syndrome in selected cases. It is a good treatment for Budd Chiari syndrome uncontrollable by medical treatment. Careful selection of patients is mandatory before TIPS, and clinical followup is essential to detect and treat complications that may result from TIPS stenosis (which can be prevented by using covered stents) and chronic encephalopathy (which may in severe cases justify reduction or occlusion of the shunt). A multidisciplinary approach, including the resources for liver transplantation, is always required to treat these patients. Hindawi Publishing Corporation 2012 2012-07-19 /pmc/articles/PMC3408669/ /pubmed/22888442 http://dx.doi.org/10.1155/2012/167868 Text en Copyright © 2012 Gilles Pomier-Layrargues et al. 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. |
spellingShingle | Review Article Pomier-Layrargues, Gilles Bouchard, Louis Lafortune, Michel Bissonnette, Julien Guérette, Dave Perreault, Pierre The Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Portal Hypertension: Current Status |
title | The Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Portal Hypertension: Current Status |
title_full | The Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Portal Hypertension: Current Status |
title_fullStr | The Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Portal Hypertension: Current Status |
title_full_unstemmed | The Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Portal Hypertension: Current Status |
title_short | The Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Portal Hypertension: Current Status |
title_sort | transjugular intrahepatic portosystemic shunt in the treatment of portal hypertension: current status |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408669/ https://www.ncbi.nlm.nih.gov/pubmed/22888442 http://dx.doi.org/10.1155/2012/167868 |
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