alexa Transjugular intrahepatic portosystemic shunt placement in patients with cirrhosis and concomitant portal vein thrombosis.
Gastroenterology

Gastroenterology

Journal of Gastrointestinal & Digestive System

Author(s): Van Ha TG, Hodge J, Funaki B, Lorenz J, Rosenblum J,

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Abstract PURPOSE: To determine the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) creation in patients with liver cirrhosis complicated by thrombosed portal vein. METHODS: This study reviewed 15 cases of TIPS creation in 15 cirrhotic patients with portal vein thrombosis at our institution over an 8-year period. There were 2 women and 13 men with a mean age of 53 years. Indications were refractory ascites, variceal hemorrhage, and refractory pleural effusion. Clinical follow-up was performed in all patients. RESULTS: The technical success rate was 75\% (3/4) in patients with chronic portal vein thrombosis associated with cavernomatous transformation and 91\% (10/11) in patients with acute thrombosis or partial thrombosis, giving an overall success rate of 87\%. Complications included postprocedural encephalopathy and localized hematoma at the access site. In patients with successful shunt placement, the total follow-up time was 223 months. The 30-day mortality rate was 13\%. Two patients underwent liver transplantation at 35 days and 7 months, respectively, after TIPS insertion. One patient had an occluded shunt at 4 months with an unsuccessful revision. The remaining patients had functioning shunts at follow-up. CONCLUSION: TIPS creation in thrombosed portal vein is possible and might be a treatment option in certain patients. This article was published in Cardiovasc Intervent Radiol and referenced in Journal of Gastrointestinal & Digestive System

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