| Emerging issues in the use of transjugular intrahepatic portosystemic shunt (TIPS) for management of portal hypertension: time to update the guidelines? | |
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MedLine Citation:
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PMID: 20036625 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Since its first introduction in the 1980s, transjugular intrahepatic portosystemic shunt has played an increasingly important role in the management and treatment of the complications of portal hypertension. In 2005, the American Association for the Study of Liver Diseases published the Practice Guidelines for the use of transjugular intrahepatic portosystemic shunt in the management of portal hypertension. Since then, technical advances and new interesting data on transjugular intrahepatic portosystemic shunt have been presented in the literature. The present review focus on the applications of transjugular intrahepatic portosystemic shunt and examines more recent studies on this topic; the current guidelines on the use of transjugular intrahepatic portosystemic shunt are also discussed. From the data presented in the most recent publications, it has become increasingly clear that the recommendations stemming from the current guidelines need to be reviewed and updated in several points. Changes in the American Association for the Study of Liver Diseases Practice Guidelines are needed for both common indications (variceal bleeding and refractory ascites) as well as uncommon ones (i.e., Budd-Chiari syndrome and portal cavernoma). In addition, a relevant technical advance has been the introduction of the polytetrafluoroethylene-covered stents, which greatly improved the patency and clinical efficacy of transjugular intrahepatic portosystemic shunt. Consequently, new studies are required to re-assess the role of transjugular intrahepatic portosystemic shunt performed with new covered stents as compared with other strategies in the management of portal hypertension. |
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Authors:
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Oliviero Riggio; Lorenzo Ridola; Cristina Lucidi; Stefania Angeloni |
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Publication Detail:
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Type: Journal Article; Review Date: 2009-12-29 |
Journal Detail:
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Title: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver Volume: 42 ISSN: 1878-3562 ISO Abbreviation: Dig Liver Dis Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-08-05 Completed Date: 2010-12-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100958385 Medline TA: Dig Liver Dis Country: Netherlands |
Other Details:
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Languages: eng Pagination: 462-7 Citation Subset: IM |
Copyright Information:
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(c) 2009 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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II Gastroenterologia, Dipartimento di Medicina Clinica, Università di Roma La Sapienza, Viale dell'Università 37, 00185 Rome, Italy. oliviero.riggio@uniroma1.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Budd-Chiari Syndrome
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therapy Esophageal and Gastric Varices Hemorrhage / prevention & control* Humans Hypertension, Portal / therapy* Portasystemic Shunt, Transjugular Intrahepatic / standards* Practice Guidelines as Topic Thrombosis / therapy |
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