Balloon Occlusion Portography to Diagnose New-Onset Left Hepatic Vein Thrombosis and Widening of an Existing Wallstent TIPS by Palmaz Stents for Recurrent Portal Hypertension and Variceal Bleeding

1996 ◽  
Vol 19 (5) ◽  
pp. 368-370
Author(s):  
Constantin Cope ◽  
Richard A. Baum ◽  
Ziv J. Haskal
1997 ◽  
Vol 78 (04) ◽  
pp. 1297-1298 ◽  
Author(s):  
Marie-Hélène Denninger ◽  
Dominique Helley ◽  
Dominique Valla ◽  
Marie-Claude Guillin

Gut ◽  
1998 ◽  
Vol 43 (1) ◽  
pp. 146.3-146
Author(s):  
R DAS ◽  
G GAREWAL ◽  
Y CHAWLA ◽  
R K DHIMAN

1993 ◽  
Vol 2 (3) ◽  
pp. 196-201 ◽  
Author(s):  
L Adams ◽  
MC Soulen

BACKGROUND: Standard medical therapies for variceal bleeding secondary to portal hypertension (vasopressin, esophagogastric balloon tamponade and sclerotherapy) are associated with high rates of recurrent bleeding. Surgical shunting has a mortality rate of 15% to 50%. The transjugular intrahepatic portosystemic shunt offers a novel, minimally invasive procedure for nonsurgical portal decompression. METHOD: Following catheterization of the hepatic vein from a jugular vein approach, a needle is directed fluoroscopically from the hepatic vein into a branch of the portal vein along an intrahepatic tract. The intrahepatic tract is then dilated and held open with a stainless steel stent delivered on a balloon catheter. This creates a portosystemic shunt entirely within the liver. RESULTS: The collective experience of more than 300 cases from several centers has been reported. The technical success rate for the transjugular intrahepatic portosystemic shunt is 92% to 96%. Thirty-day mortality rates range from 0% to 14%, with less than 3% attributed to procedural complications. Primary shunt patency is about 90%, with a secondary patency rate of 100%. Rates of encephalopathy and rebleeding are 9% to 14%. Ascites resolves in 80% to 90% of patients. CONCLUSION: The transjugular intrahepatic portosystemic shunt appears to be a safe and effective procedure for management of variceal bleeding and holds promise for becoming the treatment of choice for portal hypertension.


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