Severe ascites: efficacy of the transjugular intrahepatic portosystemic shunt in treatment
| Autor: | Melvin E. Clouse, W D Lewis, F D Gordon, Laura J. Perry, George G. Hartnell, Roger L. Jenkins, W B Crenshaw, Niall McEniff, Harry Anastopoulos, Hugh G. Wheeler |
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| Rok vydání: | 1996 |
| Předmět: |
Adult
Liver Cirrhosis Male Reoperation medicine.medical_specialty Cirrhosis medicine.medical_treatment Hepatic Veins Kidney Gastroenterology Postoperative Complications Recurrence Internal medicine Jugular vein Ascites medicine Paracentesis Humans Portasystemic Shunt Surgical Radiology Nuclear Medicine and imaging Prospective Studies Vascular Patency Aged medicine.diagnostic_test business.industry Portal Vein Middle Aged medicine.disease Surgery Shunt (medical) Liver Transplantation Treatment Outcome Effusion Liver Female medicine.symptom Complication business Transjugular intrahepatic portosystemic shunt |
| Zdroj: | Radiology. 200(1) |
| ISSN: | 0033-8419 |
| Popis: | To evaluate the transjugular intrahepatic portosystemic shunt (TIPS) as primary treatment in patients with cirrhosis and severe ascites.A TIPS placement was attempted in 54 consecutive patients with intractable ascites. Clinical assessment findings, shunt patency, complications, and survival were analyzed.A TIPS was successfully placed in 50 patients (93%). Follow-up for clinical effectiveness in 51 patients was a mean of 285 days (range, 1-981 days). Forty patients (78%) gained clinical benefit from the shunt. Of these, 29 (57%) had a complete response (required no further paracentesis) and 11 patients (22%) had a partial response (required less frequent but additional paracentesis for control of ascites). The absence of preprocedure renal insufficiency (creatinine1.5 mg/dL [130 mumol/L]) was the only characteristic identified as an indicator of clinical success (P.05). Eleven patients (22%) required shunt revision during follow-up to gain or prolong control of symptoms. Cumulative survival in the population evaluated for clinical efficacy was 53% at 6 months and 48% at 1 year. A complete response was the only variable that indicated increased survival (P.05; R2 = 12%) with a 6-month survival rate of 76% and a 1-year rate of 71%.TIPS placement appears to be effective as a primary treatment of patients with cirrhosis and severe ascites. |
| Databáze: | OpenAIRE |
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