Transjugular intrahepatic portosystemic shunt in patients with splanchnic vein thrombosis: Prevalence and management of patent foramen ovale.

Autor: Becchetti C; Hepatology and Gastroenterology Unit, ASST GOM Niguarda, Milan, Italy., De Nicola S; Division of Internal Medicine and Hepatology, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy., Gallo C; Hepatology and Gastroenterology Unit, ASST GOM Niguarda, Milan, Italy.; Division of Gastroenterology, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy., Perricone G; Hepatology and Gastroenterology Unit, ASST GOM Niguarda, Milan, Italy., Annoni G; Pediatric Cardiology, ASST GOM Niguarda, Milan, Italy., Solcia M; Interventional Radiology Unit, ASST GOM Niguarda, Milan, Italy., Musca F; Cardiology Division, De Gasperis Cardio Center, ASST GOM Niguarda, Milan, Italy., Alfonsi A; Interventional Radiology Unit, ASST GOM Niguarda, Milan, Italy., Morelli F; Interventional Radiology Unit, ASST GOM Niguarda, Milan, Italy., Barbosa F; Interventional Radiology Unit, ASST GOM Niguarda, Milan, Italy., Brambillasca PM; Interventional Radiology Unit, ASST GOM Niguarda, Milan, Italy., Rampoldi A; Interventional Radiology Unit, ASST GOM Niguarda, Milan, Italy., Airoldi A; Hepatology and Gastroenterology Unit, ASST GOM Niguarda, Milan, Italy., Belli LS; Hepatology and Gastroenterology Unit, ASST GOM Niguarda, Milan, Italy.
Jazyk: angličtina
Zdroj: Liver international : official journal of the International Association for the Study of the Liver [Liver Int] 2024 Sep; Vol. 44 (9), pp. 2458-2468. Date of Electronic Publication: 2024 Jun 22.
DOI: 10.1111/liv.16013
Abstrakt: Background and Aims: Transjugular intrahepatic portosystemic shunt (TIPS) is an established procedure for the treatment of several complications of portal hypertension (PH), including non-neoplastic portal vein thrombosis (PVT). Selection criteria for TIPS in PVT are not yet well established. Despite anecdotal, cases of thromboembolic events from paradoxical embolism due to the presence of patent foramen ovale (PFO) after TIPS placement have been reported in the literature. Therefore, we aimed at describing our experience in patients with non-neoplastic splanchnic vein thrombosis (SVT) who underwent TIPS following PFO screening.
Methods: We conducted a single-centre retrospective study, including consecutive patients who underwent TIPS for the complications of cirrhotic and non-cirrhotic portal hypertension (NCPH) and having SVT.
Results: Of 100 TIPS placed in patients with SVT, 85 patients were screened for PFO by bubble-contrast transthoracic echocardiography (TTE) with PFO being detected in 22 (26%) cases. PFO was more frequently detected in patients with non-cirrhotic portal hypertension (NCPH) (23% in the PFO group vs. 6% in those without PFO, p = .04) and cavernomatosis (46% in the PFO group vs. 19% in those without PFO, p = .008). Percutaneous closure was effectively performed in 11 (50%) after multidisciplinary evaluation of anatomical and clinical features. No major complications were observed following closure.
Conclusions: PFO screening and treatment may be considered feasible for patients with SVT who undergo TIPS placement.
(© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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