Document Detail

Transjugular intrahepatic portosystemic stent-shunt: technical factors and new developments.
MedLine Citation:
PMID:  17033430     Owner:  NLM     Status:  MEDLINE    
The introduction of expandable metal stents in the mid 1980s led to the development of transjugular intrahepatic portosystemic stent-shunt (TIPSS) as we know it today. Short-lived detrimental effects on the hyperdynamic circulation in cirrhosis accompany the acute reduction in portal pressure following TIPSS creation. Caution is needed in patients with cardiac dysfunction or pulmonary hypertension. With increasing expertise and careful patient selection, fatal procedural complications are rare and TIPSS can even be safely used as a bridge to liver transplantation. Shunt insufficiency and hepatic encephalopathy are more common following TIPSS. Currently, however, novel approaches to tackling both these limitations exist. These include the combination of uncovered TIPSS with variceal band ligation, and the introduction of polytetrafluoroethylene covered stents. Despite the lack of controlled studies, covered stents are now widely used and have the potential to drastically reduce shunt insufficiency, the need for long-term shunt surveillance and even hepatic encephalopathy.
Dhiraj Tripathi; Doris Redhead
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  18     ISSN:  0954-691X     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-11     Completed Date:  2007-01-04     Revised Date:  2009-10-16    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1127-33     Citation Subset:  IM    
Department of Hepatology, Royal Infirmary of Edinburgh, Edinburgh, UK.
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MeSH Terms
Equipment Design
Equipment Failure
Hepatic Encephalopathy / physiopathology
Hypertension, Portal / physiopathology,  surgery*
Liver Circulation
Portasystemic Shunt, Transjugular Intrahepatic* / adverse effects,  instrumentation,  methods,  trends
Reg. No./Substance:

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