Which patients benefit the most? An update on transjugular intrahepatic portosystemic shunt DOI
Ângelo Alves de Mattos, Ângelo Zambam de Mattos, Muriel Manica

et al.

World Journal of Hepatology, Journal Year: 2025, Volume and Issue: 17(2)

Published: Feb. 20, 2025

This is a narrative review in which the advances technical aspects, main indications, limitations and clinical results of transjugular intrahepatic portosystemic shunt (TIPS) portal hypertension (PH) are addressed. With emergence coated prosthesis, better patency, lower incidence hepatic encephalopathy (HE) survival when compared to TIPS with conventional prosthesis demonstrated. The indications for refractory ascites, acute variceal bleeding unresponsive pharmacological/ endoscopic therapy and, lastly, patients considered at high risk rebleeding preemptive (pTIPS). Absolute contraindications use severe uncontrolled HE, systemic infection or sepsis, congestive heart failure, pulmonary arterial hypertension, biliary obstruction. control hemorrhage due rupture can reach up 90%-100% cases, 55% ascites. Despite evidences regarding pTIPS rebleeding, less than 20% eligible treated. may also decrease future decompensation cirrhosis increase selected patients. In conclusion, an essential treatment PH, but often neglected. It important hepatologist form multidisciplinary team, role radiologist experience interventional procedures prominent.

Language: Английский

Comprehensive approach to esophageal variceal bleeding: From prevention to treatment DOI

Sahib Singh,

Saurabh Chandan,

Rakesh Vinayek

et al.

World Journal of Gastroenterology, Journal Year: 2024, Volume and Issue: 30(43), P. 4602 - 4608

Published: Oct. 31, 2024

Esophageal variceal bleeding is a severe complication often associated with portal hypertension, commonly due to liver cirrhosis. Prevention and treatment of this condition are critical for patient outcomes. Preventive strategies focus on reducing hypertension prevent varices from developing or enlarging. Primary prophylaxis involves the use non-selective beta-blockers, such as propranolol nadolol, which lower pressure by decreasing cardiac output thereby blood flow varices. Endoscopic ligation (EVL) may also be employed primary initial episodes. Once occurs, immediate essential. Initial management includes hemodynamic stabilization followed pharmacological therapy vasoactive drugs octreotide terlipressin control bleeding. intervention cornerstone treatment, techniques EVL sclerotherapy applied directly manage In cases where refractory endoscopic transjugular intrahepatic portosystemic shunt considered effectively reduce pressure. Long-term after an acute episode secondary using beta-blockers repeated sessions rebleeding, complemented monitoring managing function address underlying disease. light new scientific evidence, including findings study Peng et al , editorial aims review available prevention esophageal

Language: Английский

Citations

3
TIPS and hepatic encephalopathy in patients with cirrhosis DOI

Pauline Bozon-Rivière,

Marika Rudler, Nicolas Weiss

et al.

Metabolic Brain Disease, Journal Year: 2025, Volume and Issue: 40(2)

Published: Feb. 4, 2025

Language: Английский

Citations

0
Which patients benefit the most? An update on transjugular intrahepatic portosystemic shunt DOI
Ângelo Alves de Mattos, Ângelo Zambam de Mattos, Muriel Manica

et al.

World Journal of Hepatology, Journal Year: 2025, Volume and Issue: 17(2)

Published: Feb. 20, 2025

This is a narrative review in which the advances technical aspects, main indications, limitations and clinical results of transjugular intrahepatic portosystemic shunt (TIPS) portal hypertension (PH) are addressed. With emergence coated prosthesis, better patency, lower incidence hepatic encephalopathy (HE) survival when compared to TIPS with conventional prosthesis demonstrated. The indications for refractory ascites, acute variceal bleeding unresponsive pharmacological/ endoscopic therapy and, lastly, patients considered at high risk rebleeding preemptive (pTIPS). Absolute contraindications use severe uncontrolled HE, systemic infection or sepsis, congestive heart failure, pulmonary arterial hypertension, biliary obstruction. control hemorrhage due rupture can reach up 90%-100% cases, 55% ascites. Despite evidences regarding pTIPS rebleeding, less than 20% eligible treated. may also decrease future decompensation cirrhosis increase selected patients. In conclusion, an essential treatment PH, but often neglected. It important hepatologist form multidisciplinary team, role radiologist experience interventional procedures prominent.

Language: Английский

Citations

0