Evolving Indications for Tips
| Autor: | Mitchell T. Smith, Janette D. Durham |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Liver Cirrhosis
medicine.medical_specialty medicine.medical_treatment Liver transplantation Esophageal and Gastric Varices Risk Assessment 03 medical and health sciences 0302 clinical medicine Postoperative Complications Refractory Hepatorenal syndrome Risk Factors Hypertension Portal medicine Humans Radiology Nuclear Medicine and imaging In patient Covered stent Venous Thrombosis business.industry Patient Selection Ascites medicine.disease Surgery Portal vein thrombosis Liver Transplantation Treatment Outcome 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Radiology Refractory ascites Portasystemic Shunt Transjugular Intrahepatic Cardiology and Cardiovascular Medicine business Gastrointestinal Hemorrhage Transjugular intrahepatic portosystemic shunt |
| Zdroj: | Techniques in vascular and interventional radiology. 19(1) |
| ISSN: | 1557-9808 |
| Popis: | Transjugular intrahepatic portosystemic shunt creation is a well-established therapy for refractory variceal bleeding and refractory ascites in patients who do not tolerate repeated large volume paracentesis. Experience and technical improvements including covered stents have led to improved TIPS outcomes that have encouraged an expanded application. Evidence for other less frequent indications continues to accumulate, including the indications of primary prophylaxis in patients with high-risk acute variceal bleeding, gastric and ectopic variceal bleeding, primary treatment of medically refractory ascites, recurrent refractory ascites following liver transplantation, hepatic hydrothorax, hepatorenal syndrome, Budd-Chiari syndrome, and portal vein thrombosis. Treatment of patients with high-risk acute variceal bleeding with early TIPS and using transjugular intrahepatic portosystemic shunts as a primary therapy rather than large volume paracentesis for refractory ascites would likely be the 2 circumstances that permit expansion in the frequency of TIPS procedures. The remaining populations discussed above are relatively rare. |
| Databáze: | OpenAIRE |
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