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Transjugular intrahepatic portosystemic shunts (TIPS) are an established method for the treatment of the complications of portal hypertension. Recent reports have suggested that TIPS require frequent follow-up and may interfere with orthotopic liver transplantation (OLT),
Retrospective chart review was performed of ultrasound studies, angiographic studies, and complications of the first 100 patients treated consecutively with TIPS from February 1992 through October 1995.
Ninety-seven patients had functional TIPS. Thirty-one percent of patients treated emergently survived, significantly less than the 96% survival of elective patients. Fifty percent of the shunts were found to require angioplasty by 5 months. Seventeen patients treated with OLT did well, without intraoperative bleeding problems, and are alive.
The TIPS method treats successfully the complications of portal hypertension but requires careful follow-up. The technique may be used prior to OLT. For non-OLT candidates, the cost effectiveness of TIPS versus surgical shunting remains in question.
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- Formation of intrahepatic portosystemic shunts using a balloon dilatation catheter: Preliminary clinical experience.Am J Radiology. 1983; 140: 709-714
- Der intrahepatische portosystemische shunt: erste klinische erfahrungen bei patienten mit leberzirrhose.Dtsch Med Wschr. 1989; 114: 1511-1516
- Creation of transjugular intrahepatic portosystemic shunts with the Wallstent endoprosthesis: results in 100 patients.Radiology. 1993; 187: 413-420
- The role of transjugular intrahepatic portosystemic shunts in the management of patients with end-stage liver disease.Am J Surg. 1994; 168: 592-597
- Using transjugular intrahepatic portosystemic shunts to control variceal bleeding before liver transplantation.Ann Intern Med. 1992; 116: 304-309
- Intrahepatic portosystemic vascular stents: a bridge to hepatic transplantation.Surgery. 1993; 113: 344-351
- Critical appraisal of the angiographic portacaval shunt (TIPS).Am J Surg. 1993; 165: 566-571
- Hepatic encephalopathy after transjugular intrahepatic portosystemic shunts: incidence and risk factors.Am J Gastroenterol. 1995; 90: 549-555
- Histopathologic study of stenotic and occluded transjugular intrahepatic portosystemic shunts.J Vasc Interv Radiol. 1993; 4: 779-786
- Development of stenoses in transjugular intrahepatic portosystemic shunts.Radiology. 1994; 192: 231-234
- Transjugular intrahepatic portosystemic shunt stenosis and revision: early and midterm results.Am J Roentegenol. 1994; 163: 439-444
- Transjugular intrahepatic portosystemic shunts using the wallstent prosthesis: a follow-up study.Cardiovasc Intervent Radiol. 1994; 17: 7-11
- Liver transplantation complicated by malpositioned transjugular intrahepatic portosystemic shunts.J Vas Interv Radiol. 1995; 6: 695-699
- Design, analysis of randomized clinical trials requiring prolonged observation of each patient: II. Analysis and examples.Br J Cancer. 1977; 35: 1-39
- Transection of the oesophagus for bleeding oesophageal varices.Brit J Surg. 1973; 60: 646-649
- Is portal-systemic shunt worthwhile in Child's class C cirrhosis?.Ann Surg. 1992; 216: 256-268
- Early sonographic evaluation of the transjugular intrahepatic portosystemic shunt (TIPS).Cardiovasc Intervent Radiol. 1993; 16: 275-279
- Duplex and color doppler sonography of complications after percutaneous interventional vascular procedures.Radiographics. 1994; 14: 239-253
- Detection of transjugular portosystemic shunt dysfunction: value of duplex doppler sonograph.Am J Roentgenol. 1995; 164: 1119-1124
- A retrospective study of the efficacy of transjugular intrahepatic portosystemic shunts.Am Surg. 1996; 62: 76-80
- A comparative study of emergency transjugular intrahepatic portosystemic stem-shunt and esophageal transection in the management of uncontrolled variceal hemorrhage.Am J Gastroenterol. 1995; 90: 1932-1937
- Mesocaval shunts for the control of bleeding esophageal varices.Surgery. 1979; 85: 257-262
*Presented at the 48th Annual Meeting of the Southwestern Surgical Congress, Scottsdale, Arizona, April 28–May 1, 1996.
© 1996 Excerpta Medica, Inc. All rights reserved. Published by Elsevier Inc.