Elas podem ser observadas na endoscopia. Epidemiology of hepatitis B in Europe and worldwide. J Hepatol. Burden of liver disease in the United States: summary of a workshop. Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices.
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A taxa de ressangramento foi significativamente menor nos pacientes que receberam o TIPS. TIPS - transjugular intrahepatic portosystemic shunt. A review. Arq Gastroenterol ;38 1 We will review the main medical publications on transjugular intrahepatic portosystemic shunt TIPS , a procedure seldom used among us.
TIPS works as a portocaval side-to-side shunt and decreases the risk of esophageal bleeding through lowering of the portal system pressure and a decrease of the portal hepatic pressure gradient. TIPS consists in the percutaneous insertion, through the internal jugular vein, of a metallic stent under fluoroscopic control in the hepatic parenchyma creating a true porta caval communication.
There are several studies demonstrating the efficacy of TIPS, although only a few of them are randomized and control-matched to allow us to conclude that this procedure is safe, efficient and with a good cost benefit ratio.
In this review, we search for the analysis of the TIPS utilization, its techniques, its major indications and complications. TIPS has been used in cases of gastroesophageal bleeding that has failed with pharmacologic or endoscopic treatment in patients Child-Pugh B and C. It can be used also as a bridge for liver transplantation.
Others indications for TIPS are uncontrolled ascites, hepatic renal syndrome, and hepatic hydrotorax. The main early complications of TIPS using are related to the insertion site and hepatic encephalopathy and the stent occlusion is the chief late complication. Hypertension, portal. Liver cirrhosis. A comparison of treatment with TIPS or distal splenorenal shunt in the management of variceal bleeding prior to liver transplantation.
Transplantation ; Hepatic hydrothorax: cause and manangement. Arch Med Intern ; Improvement of thrombocytopenia due to hypersplenism after TIPS placement in cirrhotic patients.
Am J Gastroenterol ; TIPS for the manangement of hepatic hydrothorax in the abscence of ascites. J Clin Gastroenterol ; Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. Hepatology ; Portal systemic shunt in hepatic cirrhosis: does the type of shunt decisively influence the clinical result?
Ann Surg ; Radiology ; Endoscopic sclerotherapy compared with percutaneous TIPS after initial sclerotherapy in patients with acute variceal hemorrhage. Ann Intern Med ; Liver transplantation complicated by misplaced TIPS in the portal vein.
Creation of an intrahepatic portosystemic shunt with a Gruntzig balloon catheter. Can Med Assoc J ; Conn HO. TIPS: the state of the art. The treatment of portal hypertension: a meta-analytic review. Cardiovasc Intervent Radiol ; TIPS vs propranolol plus isosorbide 5-mononitrate for the prevention of variceal rebleeding in patients with cirrhosis.
Hepatology ;A. The role of transjugular portal-systemic shunt in the manangement of variceal bleeding. Clin Liver Dis ; Refractory ascites: early experience in the treatment with TIPS.
Techniques for TIPS revision. Duplex sonography after TIPS: normal hemodynamic findings and efficacy in predicting shunt patency and stenosis. Should portosystemic shunt be reconsidered in the treatment of intractable ascites in cirrhosis? Arch Surg ; Results with percutaneous TIPS for control of variceal hemorrhage in patients awaiting liver transplantation. Transplant Proc ; Freeman RB Jr. Is the TIPS procedure beneficial for liver transplant recipients? TIPS for the manangement of severe venoocclusive disease following bone marrow transplantation.
Transjugular intrahepatic portosystemic shunt TIPS for Budd-Chiari syndrome or portal vein thrombosis: review of indications and problems. TIPS versus endoscopic sclerotherapy for the prevention of variceal rebleeding after recent variceal hemorrhage. Renal effects of TIPS in cirrhosis: comparison of patients with ascites, with refractory ascites, or without ascites.
TIPS for variceal bleeding in portal hypertension. Comparison of emergency and elective interventions. Dig Dis Sci ; Incidence, predictive factors, and prognosis of the hepatorenal syndrome in cirrhosis with ascites. Gastroenterology ; The successful treatment of syntomatic, refractory hepatic hydrothorax with TIPS. Grace ND. Diagnosis and treatment of gastrointestinal bleeding secondary to portal hypertension.
Grace ND, Bhattacharya K. Pharmacologic therapy of portal hypertension and variceal hemorrhage. Groupe de Etude des Anastomosis Intra-hepatiques. TIPS vs. Hepatology ;A Clinical outcome two years after implantation of TIPS for recurrent variceal bleeding.
Eur J Gastroenterol Hepatol ; Acute and chronic complications after implantation of a TIPS - a prospective study in 53 patients. Z Gastroenterol ; TIPS in hepatorenal syndrome: effects on renal function and vasoactive systems. Intestinal varices: treatment with TIPS. Sonography of TIPS: detection of elevated portosystemic gradients and loss of shunt function.
J Vasc Interv Radiol ; The reducing stent: treatment for TIPS induced refractory hepatic encephalopathy and liver failure. A randomized trial comparing TIPS with variceal band ligation in the prevention of rebleeding from esophageal varices. TIPS and liver transplantation in patients with refractory hepatic hydrothorax. Liver Transpl Surg ; Recurrent bleeding from anorectal varices: successful treatment with a TIPS.
Kerlan RK Jr. Successful reversal of hepatic encephalopathy with intentional occlusion of TIPS. TIPS: current status. Pulmonary aspects of liver disease and liver transplantation. Clin Chest Med Histopathologic study of stenotic and occluded TIPS. Creation of TIPS with the wallstent endoprosthesis: results in patients. Two-year outcome following TIPS for variceal bleeding: results in 90 patients. TIPS: comparison with paracentesis in patients with cirrhosis and refractory ascites: a randomized trial.
J Hepatol ; Successful treatment of severe hepatic veno-occlusive disease after allogenic bone marrow transplantation by TIPS. Bone Marrow Transplant ; Incidence of shunt occlusion or stenosis following TIPS placement. Transjugular intrahepatic portosystemic shunt after previous recanalization of a chronically thrombosed portal vein via a transmesenteric approach. Beware of TIPS in liver transplant candidates. Hepatogastroenterology ; TIPS: impact on liver transplantation.
Long-term follow up after TIPS: use of Doppler velocity criteria for detecting elevation of the portosystemic gradient.
The TIPS procedure for refractory ascites.
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