scholarly journals High Prevalence of Transjugular Intrahepatic Portosystemic Shunt Creation Without Prior Endoscopy During Acute Variceal Bleeding Hospitalization in the United States

2021 ◽  
Author(s):  
Premal S. Trivedi ◽  
Alexandria M. Jensen ◽  
Matthew A. Brown ◽  
Rustain L. Morgan ◽  
Richard C. Lindrooth ◽  
...  
Keyword(s):  
United States ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Variceal Bleeding ◽  
The United States ◽  
Portosystemic Shunt ◽  
Acute Variceal Bleeding ◽  
High Prevalence ◽  
Intrahepatic Portosystemic Shunt

scholarly journals Hospital volume and mortality after transjugular intrahepatic portosystemic shunt creation in the United States

Hepatology ◽  
2017 ◽  
Vol 67 (2) ◽  
pp. 690-699 ◽  
Author(s):  
Ammar Sarwar ◽  
Lujia Zhou ◽  
Victor Novack ◽  
Elliot B. Tapper ◽  
Michael Curry ◽  
...  
Keyword(s):  
United States ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Hospital Volume ◽  
The United States ◽  
Portosystemic Shunt ◽  
Intrahepatic Portosystemic Shunt

scholarly journals The role of pre-emptive Transjugular Intrahepatic Portosystemic Shunt in acute variceal bleeding: a literature review

2021 ◽  
Vol 12 ◽  
pp. 204062232199577
Author(s):  
Charelle Manning ◽  
Amera Elzubeir ◽  
Syed Alam
Keyword(s):  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Variceal Bleeding ◽  
Standard Of Care ◽  
Portosystemic Shunt ◽  
Emergency Setting ◽  
Acute Variceal Bleeding ◽  
Variceal Bleed ◽  
Intrahepatic Portosystemic Shunt ◽  
History Of

The development of portal hypertension has serious implications in the natural history of liver cirrhosis, leading to complications such as ascites, hepatic encephalopathy and variceal bleeding. The management of acute variceal bleeding has improved in the last two decades, but despite the advances in endoscopic methods the overall prognosis remains poor, particularly within a subgroup of patients with more advanced disease. The role of Transjugular Intrahepatic Portosystemic Shunt (TIPSS) is a well-established method of achieving haemostasis by immediate portal decompression; however, its use in an emergency setting as a rescue strategy is still associated with high mortality. It has been shown that ‘early’ use of TIPSS as a pre-emptive strategy in a patient with acute variceal bleed in addition to the standard of care confers superior survival outcomes in a subgroup of patients at high risk of treatment failure and death. The purpose of this review is to appraise the literature around the indications, patient selection, utility, complications and economic considerations of pre-emptive TIPSS.

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