scholarly journals Embolization of large spontaneous portosystemic shunts for refractory hepatic encephalopathy: A multicenter survey on safety and efficacy

Hepatology ◽  
2013 ◽  
Vol 57 (6) ◽  
pp. 2448-2457 ◽  
Author(s):  
Wim Laleman ◽  
Macarena Simon-Talero ◽  
Geert Maleux ◽  
Mercedes Perez ◽  
Koen Ameloot ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Safety And Efficacy ◽  
Portosystemic Shunts ◽  
Multicenter Survey ◽  
Refractory Hepatic Encephalopathy

scholarly journals Embolization of portosystemic shunts for treatment of medically refractory hepatic encephalopathy

2016 ◽  
Vol 22 (6) ◽  
pp. 723-731 ◽  
Author(s):  
Amanda M. Lynn ◽  
Siddharth Singh ◽  
Stephen E. Congly ◽  
Disha Khemani ◽  
David H. Johnson ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Portosystemic Shunts ◽  
Refractory Hepatic Encephalopathy

Embolization of portosystemic shunts for treatment of medically refractory hepatic encephalopathy

2016 ◽  
Vol 22 (12) ◽  
pp. 1734-1735 ◽  
Author(s):  
Amir Kashani ◽  
H. G. Lipshutz ◽  
Andrew S. Klein ◽  
Irene Kim ◽  
Marc L. Friedman ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Portosystemic Shunts ◽  
Refractory Hepatic Encephalopathy

scholarly journals Portosystemic shunts and refractory hepatic encephalopathy: patient selection and current options

2019 ◽  
Vol Volume 11 ◽  
pp. 23-34 ◽  
Author(s):  
Cyriac Abby Philips ◽  
Sasidharan Rajesh ◽  
Philip Augustine ◽  
Guruprasad Padsalgi ◽  
Rizwan Ahamed
Keyword(s):  
Hepatic Encephalopathy ◽  
Patient Selection ◽  
Portosystemic Shunts ◽  
Refractory Hepatic Encephalopathy

scholarly journals Vascular Plug-Assisted Retrograde Transvenous Obliteration of Portosystemic Shunts for Refractory Hepatic Encephalopathy: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Jonathan K. Park ◽  
Sung-Ki Cho ◽  
Stephen Kee ◽  
Edward W. Lee
Keyword(s):  
Case Report ◽  
Hepatic Encephalopathy ◽  
Portosystemic Shunt ◽  
Vascular Plug ◽  
Portosystemic Encephalopathy ◽  
Portosystemic Shunts ◽  
American Case ◽  
Refractory Hepatic Encephalopathy ◽  
Shunt Closure ◽  
Emerging Therapy

While balloon-assisted retrograde transvenous obliteration (BRTO) has been used for two decades in Asia for the management of gastric variceal bleeding, it is still an emerging therapy elsewhere. Given the shunt closure brought about by the procedure, BRTO has also been used for the management of portosystemic encephalopathy with promising results. Modified versions of BRTO have been developed, including plug-assisted retrograde transvenous obliteration (PARTO), where a vascular plug is deployed within a portosystemic shunt. To our knowledge, we present the first North American case of PARTO in the setting of a large splenorenal shunt for the management of portosystemic encephalopathy.

scholarly journals Total area of spontaneous portosystemic shunts independently predicts hepatic encephalopathy and mortality in liver cirrhosis

2020 ◽  
Vol 72 (6) ◽  
pp. 1140-1150 ◽  
Author(s):  
Michael Praktiknjo ◽  
Macarena Simón-Talero ◽  
Julia Römer ◽  
Davide Roccarina ◽  
Javier Martínez ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Portosystemic Shunts

Transjugular Intrahepatic Portosystemic Shunts in High-Risk Patients

2020 ◽  
Vol 04 (02) ◽  
pp. 148-156
Author(s):  
David S. Shin ◽  
Hong Vo ◽  
Guy Johnson ◽  
Raimund Pichler ◽  
Scott W. Biggins
Keyword(s):  
High Risk ◽  
Cardiac Disease ◽  
Poor Prognosis ◽  
Hepatic Malignancy ◽  
Safety And Efficacy ◽  
End Stage Liver Disease ◽  
The Past ◽  
Portosystemic Shunts ◽  
Risk Patients ◽  
End Stage

AbstractCirrhosis with complications of portal hypertension portends a poor prognosis. Transjugular intrahepatic portosystemic shunts (TIPS) can successfully treat some of these complications in select patients. While the safety and efficacy of TIPS have improved significantly over the past decade, certain patients are categorized as high-risk based on various demographic, laboratory, and comorbid factors. Herein, we provide an in-depth review of TIPS in these settings, including high model for end-stage liver disease score, hepatic malignancy, advanced age, cardiac disease, renal dysfunction, and pregnancy, and discuss their impact on patient selection and procedural considerations.

scholarly journals Spontaneous portosystemic shunts in liver cirrhosis: new approaches to an old problem

2020 ◽  
Vol 13 ◽  
pp. 175628482096128 ◽  
Author(s):  
Judit Vidal-González ◽  
Sergi Quiroga ◽  
Macarena Simón-Talero ◽  
Joan Genescà
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Portosystemic Shunt ◽  
Venous System ◽  
Variceal Hemorrhage ◽  
Portal Venous System ◽  
Portal Flow ◽  
Portosystemic Shunts ◽  
Intrahepatic Portosystemic Shunt

Portal hypertension is the main consequence of liver cirrhosis, leading to severe complications such as variceal hemorrhage, ascites or hepatic encephalopathy. As an attempt to decompress the portal venous system, portal flow is derived into the systemic venous system through spontaneous portosystemic shunts (SPSSs), bypassing the liver. In this review, we aim to provide an overview of the published reports in relation to the prevalence and physiopathology behind the appearance of SPSS in liver cirrhosis, as well as the complications derived from its formation and its management. The role of SPSS embolization is specifically discussed, as SPSSs have been assessed as a therapeutic target, mainly for patients with recurrent/persistent hepatic encephalopathy and preserved liver function. Furthermore, different aspects of the role of SPSS in liver transplantation, as well as in candidates for transjugular intrahepatic portosystemic shunt are reviewed. In these settings, SPSS occlusion has been proposed to minimize possible deleterious effects, but results are so far inconclusive.

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