Document Detail


Transjugular intrahepatic portosystemic shunt (TIPS): indications and long-term patency.
MedLine Citation:
PMID:  14743891     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Since the introduction of TIPS (the transjugular intrahepatic portosystemic shunt) into clinical practice in 1989, substantial knowledge, partially derived from controlled trials, has become available regarding technical and clinical aspects of the procedure. A number of prospective studies have assessed the long-term patency of radiological shunts, the recognized main technical weakness of the procedure. METHODS: Review of published data regarding the optimal indications and long-term patency of TIPS. RESULTS: Information on the long-term patency of TIPS is surprisingly scarce. Within 2 years of TIPS creation, re-interventions to re-establish or maintain the patency of the shunt are required in 70%-90% of patients, and in 20%-40% total occlusion develops. Limited available data suggest, however, that in about 80% of patients the shunt is patent after 3-5 years. There is consensus that TIPS is a main, second-line treatment option for variceal haemorrhage not responding to other therapies. Although widely used for treating refractory ascites, gastric variceal bleeding and Budd-Chiari syndrome, these indications require more study. A number of other potential indications remain poorly defined. CONCLUSION: TIPS is a major treatment modality to manage the complications of portal hypertension and Budd-Chiari syndrome. The available data indicate that TIPS is not only a short-term treatment option but may provide long-term portosystemic decompression. Technical improvements, e.g. the use of covered or drug-eluting stents, are essential to reduce the high rate of shunt dysfunction.
Authors:
H R van Buuren; P C J ter Borg
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Scandinavian journal of gastroenterology. Supplement     Volume:  -     ISSN:  0085-5928     ISO Abbreviation:  Scand. J. Gastroenterol. Suppl.     Publication Date:  2003  
Date Detail:
Created Date:  2004-01-27     Completed Date:  2004-05-27     Revised Date:  2008-02-13    
Medline Journal Info:
Nlm Unique ID:  0437034     Medline TA:  Scand J Gastroenterol Suppl     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  100-4     Citation Subset:  IM    
Affiliation:
Dept. of Gastroenterology and Hepatology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands. H.vanbuuren@erasmusMC.nl
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MeSH Terms
Descriptor/Qualifier:
Budd-Chiari Syndrome / surgery
Humans
Hypertension, Portal / surgery
Patient Selection
Portasystemic Shunt, Transjugular Intrahepatic / adverse effects,  methods*
Postoperative Complications*
Reoperation
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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