Journal of Vascular and Interventional Radiology, Journal Year: 2024, Volume and Issue: unknown
Published: Nov. 1, 2024
Language: Английский
Liver International, Journal Year: 2024, Volume and Issue: 44(9), P. 2125 - 2143
Published: May 17, 2024
Abstract Transjugular intrahepatic portosystemic shunt (TIPS) has become essential in the treatment or prevention of portal hypertension‐related complications. In early 1990s, primary indication was refractory bleeding. It is now proposed for ascites bleeding and patients with vascular diseases liver. Thus, there are a growing number being treated TIPS all over world. The broadening indications, involvement multiple stakeholders, need an accurate selection, positioning relation to transplantation lack standardization pre‐therapeutic assessment, procedure itself follow‐up have led board French Association Study Liver establish recommendations.
Language: Английский
Citations
3
Gastroenterology Clinics of North America, Journal Year: 2025, Volume and Issue: 54(2), P. 429 - 451
Published: Jan. 23, 2025
Language: Английский
Citations
0
Nature Medicine, Journal Year: 2025, Volume and Issue: unknown
Published: Feb. 7, 2025
Language: Английский
Citations
0
Saudi Journal of Gastroenterology, Journal Year: 2025, Volume and Issue: unknown
Published: Feb. 7, 2025
Abstract Background: Transjugular intrahepatic portosystemic shunt (TIPS) is the main method to prevent rebleeding of esophagogastric varices. Many studies have demonstrated that pre-emptive TIPS (p-TIPS) superior medicine combined with endoscopic standard therapy in efficacy high-risk patients, but very few relevant reported whether p-TIPS more effective than elective TIPS. This study aims compare and prognosis for treatment variceal bleeding (EGVB) patients cirrhosis. Methods: In this retrospective study, clinical data 92 cirrhosis who accepted after EGVB were collected. According different times TIPS, divided into group group. The following information documented: manifestations laboratory examination at 1, 3, 6 months operation, survival state, rates weeks months, postoperative complications serious adverse events during follow-up. Results: Child-Pugh score ( P = 0.002) MELD 0.006) significantly lower those th month treatment. rate no gastric coronary vein embolization was higher 0.034). hospitalized days < 0.001) costs No significant differences observed between two groups concerning rebleeding, overt hepatic encephalopathy, ascites, complications, events, occurrence. Conclusion: contributes liver function recovery enhances patient benefits 6-months postoperation compared without increasing incidence events.
Language: Английский
Citations
0
Journal of Clinical and Translational Hepatology, Journal Year: 2025, Volume and Issue: 000(000), P. 000 - 000
Published: Feb. 17, 2025
With progress in basic and clinical research on hepatic encephalopathy cirrhosis worldwide, the Chinese Society of Hepatology Medical Association has invited experts relevant fields to revise 2018 "Chinese Guidelines Management Hepatic Encephalopathy Cirrhosis." The updated guidelines provide recommendations for diagnosis, treatment, both primary secondary prevention cirrhosis.
Language: Английский
Citations
0
Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(5), P. 1491 - 1491
Published: Feb. 23, 2025
Objective: Liver cirrhosis (LC) progression induces intestinal microbiota abnormalities, such as small bacterial overgrowth (SIBO), and these changes lead to the inflow of gut pathogens their degradation products into vessels, causing cirrhotic complications hepatic encephalopathy (HE). Methods: To clarify relationship between development overt HE SIBO, we conducted a three-year observation after assessment SIBO in patients with LC. Results: In analysis 107 patients, mean follow-up duration 29.4 months, 31 were diagnosed 30 covert HE. Cox multivariate regression for prognosis, Child–Pugh score, blood urea nitrogen level, Union International Cancer Control (UICC) stage hepatocellular carcinoma derived using following five factors: white cell count, UICC stage, serum aspartate aminotransferase alkaline phosphatase levels (p = 0.002, hazard ratio [HR] 3.733, 95% confidence interval [CI] 1.592–8.754, p 0.001, HR 1.076, CI 1.030–1.123, < 2.767, 1.780–4.302, respectively). Furthermore, development, methane-producing four HE, ammonia 0.038, 5.008, 1.096–22.892 0.006, 8.597, 1.881–39.291, Conclusions: M-SIBO positivity was significant predictor
Language: Английский
Citations
0
World Journal of Hepatology, Journal Year: 2025, Volume and Issue: 17(4)
Published: April 25, 2025
Hepatic encephalopathy (HE) is a primary complication following transjugular intrahepatic portosystemic shunt (TIPS), but the utility of pharmacological prophylaxis for HE unclear. To assess incidence post-TIPS across various groups and prophylactic efficacies medications. A thorough literature search was performed in PubMed, Web Science, EMBASE, Cochrane Library databases from their inception to November 24, 2024, collect data regarding incidence. The main outcome post-TIPS. meta-analysis using random effects model obtain odds ratios (ORs) 95% confidence intervals. Statistical analyses were conducted Stata RevMan software. This included nine studies with 1140 patients; 647 received agents including lactulose, rifaximin, albumin, l-ornithin-l-aspartate, 493 did not (controls). (1) In single-group meta-analysis, control group had higher short- long-term rates than drug intervention group. Among patients without prior HE, non-intervention group's also higher; (2) Pharmacological prevention significantly reduced [OR = 0.59 (0.45, 0.77), P 0.0001]. Compared no prophylaxis, rifaximin risk after TIPS 0.52 (0.29, 0.95), 0.03], lactulose not; (3) 0.62 (0.41,0.95), 0.03]; (4) Network showed significant differences among five strategies. relatively high, use drugs may reduce However, research, especially large-scale randomized controlled trials, still lacking.
Language: Английский
Citations
0
CVIR Endovascular, Journal Year: 2025, Volume and Issue: 8(1)
Published: May 24, 2025
Abstract Purpose Assess incidence of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) in patients treated with 8-10 mm Controlled Expansion diameter VIATORR® (VCX) versus 10 first-generation (Legacy) stent-grafts. Materials and methods Single-centre retrospective study (January 2015 to March 2024), including 132 adult cirrhosis TIPS due complications portal hypertension. Outcomes included post-TIPS new onset overt HE, ascites response, re-bleeding, mortality pressure gradient (PPG) before TIPS. Comparisons used Chi square Fisher´s exact test for categorical variables Student´s t or Mann–Whitney quantitative variables. Results Indication was refractory ( n = 82) variceal bleeding 50). The VCX group 85) the Legacy 47) had similar HE: 37% (31/85) vs 43% (20/47), respectively p 0.31); rates (34% [29/85]) 39% [18/47], respectively, 0.57) re-bleeding (17% [6/35] 20% [3/15], 1.00). Median PPG reduction mmHg (7 – 13) 12 (9 15) 0.02). Subgroup analysis revealed post HE rate 38% (19/50) 53% (17/32) 0.13), as an indication. Shunt dysfunction 7% (6/85) (stent thrombosis 6, stenosis malpositioning 0) 0% (0/47) 0.09). Conclusion stent grafts induce immediate lower reduction, which might lead more dysfunctions, but also a HE.
Language: Английский
Citations
0
World Journal of Hepatology, Journal Year: 2024, Volume and Issue: 16(6), P. 891 - 899
Published: June 19, 2024
This editorial describes the milestones to optimize of transjugular intrahepatic portosystemic shunt (TIPS) technique, which have made it one main methods for treatment portal hypertension complications worldwide. Innovative ideas, subsequent experimental studies and preliminary experience use in cirrhotic patients contributed introduction TIPS into clinical practice. At moment, achievement technique is progress qualitative characteristics stents. The transition from bare metal stents extended polytetrafluoroethylene-covered stent grafts possible significantly prevent dysfunction. However, question its preferred diameter, contributes an optimal reduction pressure without risk developing post-TIPS hepatic encephalopathy, remains relevant. Currently, encephalopathy most common TIPS, affecting effectiveness prognosis. Careful selection based on cognitive indicators, nutritional status, assessment liver function,
Language: Английский
Citations
0
Annaly khirurgicheskoy gepatologii = Annals of HPB surgery, Journal Year: 2024, Volume and Issue: 29(3), P. 116 - 123
Published: Sept. 30, 2024
Aim. To describe the milestones to optimize of technique transjugular intrahepatic portosystemic shunt. Materials and methods. The PubMed Embase databases, Web Science platform, Google Scholar retrieval system, Cochrane Database Systematic Reviews, eLIBRARY.RU scientific electronic library, reference lists were used search for articles. Articles corresponding aim review selected 1969-2023. inclusion criteria limited technical solutions related Results. Innovative ideas, subsequent experimental studies preliminary experience in liver cirrhosis patients contributed introduction shunt into clinical practice. At moment, main achievement is progress qualitative characteristics stents. transition from bare metal stents expandable polytetrafluoroethylene-covered stent graft made it possible largely prevent dysfunction. However, issue its optimal diameter, contributing an effective reduction portal pressure without risk developing hepatic encephalopathy, which one most common complications shunt, remains relevant. Conclusion. Further as well careful selection based on cognitive indicators, nutritional status assessment function will reduce incidence encephalopathy improve treatment results.
Language: Английский
Citations
0