transjugular intrahepatic portasystemic shunt

Summary

Summary: A type of surgical portasystemic shunt to reduce portal hypertension with associated complications of esophageal varices and ascites. It is performed percutaneously through the jugular vein and involves the creation of an intrahepatic shunt between the hepatic vein and portal vein. The channel is maintained by a metallic stent. The procedure can be performed in patients who have failed sclerotherapy and is an additional option to the surgical techniques of portocaval, mesocaval, and splenorenal shunts. It takes one to three hours to perform. (JAMA 1995;273(23):1824-30)

Top Publications

  1. ncbi Ten years' follow-up of 472 patients following transjugular intrahepatic portosystemic stent-shunt insertion at a single centre
    Dhiraj Tripathi
    Liver Unit, The Royal Infirmary, Edinburgh, UK
    Eur J Gastroenterol Hepatol 16:9-18. 2004
  2. pmc Current management of the complications of portal hypertension: variceal bleeding and ascites
    Nina Dib
    Department of Hepato Gastroenterology, University Hospital, and HIFIH Laboratory, Universite d Angers, Angers, France
    CMAJ 174:1433-43. 2006
  3. ncbi Improved clinical outcome using polytetrafluoroethylene-coated stents for TIPS: results of a randomized study
    Christophe Bureau
    Service d Hepato gastro enterologie, Fédération Digestive, Centre Hospitalier Universitaire Purpan et U531 Institut National de la Santé et de la Recherche Médicale, Toulouse, France
    Gastroenterology 126:469-75. 2004
  4. pmc Child-Pugh versus MELD score in predicting survival in patients undergoing transjugular intrahepatic portosystemic shunt
    B Angermayr
    Department of Gastroenterology and Hepatology, University of Vienna Medical School, Austria
    Gut 52:879-85. 2003
  5. ncbi Patency of stents covered with polytetrafluoroethylene in patients treated by transjugular intrahepatic portosystemic shunts: long-term results of a randomized multicentre study
    Christophe Bureau
    Federation Digestive Purpan, Service Hepato Gastro Enterologie CHU Toulouse, Toulouse, France
    Liver Int 27:742-7. 2007
  6. ncbi Pathogenesis and treatment of hepatorenal syndrome
    Vicente Arroyo
    Liver Unit, Institute of Digestive and Metabolic Diseases, CIBERehd, Hospital Clinic, University of Barcelona, Spain
    Semin Liver Dis 28:81-95. 2008
  7. ncbi The use of E/A ratio as a predictor of outcome in cirrhotic patients treated with transjugular intrahepatic portosystemic shunt
    Rania Nancy Rabie
    The Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, Canada
    Am J Gastroenterol 104:2458-66. 2009
  8. ncbi The natural history of parallel transjugular intrahepatic portosystemic stent shunts using uncovered stent: the role of host-related factors
    Ahmed Helmy
    Department of Liver Transplantation, Hepatobiliary and Pancreatic Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
    Liver Int 26:572-8. 2006
  9. ncbi The role of transjugular intrahepatic portosystemic shunt (TIPS) in the management of portal hypertension
    Luis Colombato
    Hepatic Hemodynamic Section, Liver Unit, Gastroenterology Department, Buenos Aires British Hospital, Buenos Aires School of Medicine, Buenos Aires University, Buenos Aires, Argentina
    J Clin Gastroenterol 41:S344-51. 2007
  10. ncbi Effect of transjugular intrahepatic portosystemic shunt on pulmonary gas exchange in patients with portal hypertension and hepatopulmonary syndrome
    Graciela Martinez-Palli
    Servei d Anestesiologia i Reanimacio Hospital Clinic, Institut d Investigacions Biomediques August Pi i Sunyer IDIBAPS, Universitat de Barcelona, Barcelona, Spain
    World J Gastroenterol 11:6858-62. 2005

Research Grants

Detail Information

Publications219 found, 100 shown here

  1. ncbi Ten years' follow-up of 472 patients following transjugular intrahepatic portosystemic stent-shunt insertion at a single centre
    Dhiraj Tripathi
    Liver Unit, The Royal Infirmary, Edinburgh, UK
    Eur J Gastroenterol Hepatol 16:9-18. 2004
    ..Transjugular intrahepatic portosystemic stent-shunt (TIPSS) is increasingly used for the management of portal hypertension. We report on 10 years' experience at a single centre...
  2. pmc Current management of the complications of portal hypertension: variceal bleeding and ascites
    Nina Dib
    Department of Hepato Gastroenterology, University Hospital, and HIFIH Laboratory, Universite d Angers, Angers, France
    CMAJ 174:1433-43. 2006
    ..We describe the pathophysiology of portal hypertension and the current management of its complications, with emphasis on the prophylaxis and treatment of variceal bleeding and ascites...
  3. ncbi Improved clinical outcome using polytetrafluoroethylene-coated stents for TIPS: results of a randomized study
    Christophe Bureau
    Service d Hepato gastro enterologie, Fédération Digestive, Centre Hospitalier Universitaire Purpan et U531 Institut National de la Santé et de la Recherche Médicale, Toulouse, France
    Gastroenterology 126:469-75. 2004
    ..Preliminary experimental and clinical studies suggest that the use of stents covered with polytetrafluoroethylene could tremendously decrease this risk...
  4. pmc Child-Pugh versus MELD score in predicting survival in patients undergoing transjugular intrahepatic portosystemic shunt
    B Angermayr
    Department of Gastroenterology and Hepatology, University of Vienna Medical School, Austria
    Gut 52:879-85. 2003
    ..The Child-Pugh score (CPS) is well established but several drawbacks have led to development of the model of end stage liver disease (MELD)...
  5. ncbi Patency of stents covered with polytetrafluoroethylene in patients treated by transjugular intrahepatic portosystemic shunts: long-term results of a randomized multicentre study
    Christophe Bureau
    Federation Digestive Purpan, Service Hepato Gastro Enterologie CHU Toulouse, Toulouse, France
    Liver Int 27:742-7. 2007
    ..In conclusion, the improvement in TIPS patency by using covered prostheses is maintained over time with a decreased risk of encephalopathy, while the risk of death was not increased...
  6. ncbi Pathogenesis and treatment of hepatorenal syndrome
    Vicente Arroyo
    Liver Unit, Institute of Digestive and Metabolic Diseases, CIBERehd, Hospital Clinic, University of Barcelona, Spain
    Semin Liver Dis 28:81-95. 2008
    ..However, effective treatments of HRS (vasoconstrictors associated with intravenous albumin, transjugular intrahepatic portacaval shunt, albumin dialysis) that can improve survival have recently been introduced...
  7. ncbi The use of E/A ratio as a predictor of outcome in cirrhotic patients treated with transjugular intrahepatic portosystemic shunt
    Rania Nancy Rabie
    The Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, Canada
    Am J Gastroenterol 104:2458-66. 2009
    ..The aim of this study was to assess the utility of E/A ratio, an indicator of diastolic dysfunction, to predict ascites clearance and mortality after transjugular intrahepatic portosystemic stent shunt (TIPS) insertion...
  8. ncbi The natural history of parallel transjugular intrahepatic portosystemic stent shunts using uncovered stent: the role of host-related factors
    Ahmed Helmy
    Department of Liver Transplantation, Hepatobiliary and Pancreatic Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
    Liver Int 26:572-8. 2006
    ..This study describes the natural history of PS, and uses them as a model to assess the role of host factors in the development of primary shunt insufficiency...
  9. ncbi The role of transjugular intrahepatic portosystemic shunt (TIPS) in the management of portal hypertension
    Luis Colombato
    Hepatic Hemodynamic Section, Liver Unit, Gastroenterology Department, Buenos Aires British Hospital, Buenos Aires School of Medicine, Buenos Aires University, Buenos Aires, Argentina
    J Clin Gastroenterol 41:S344-51. 2007
    ..Pre-TIPS evaluation taking into account predictors of outcome is mandatory. The improved results achieved with covered-stents might expand the currently accepted recommendations for TIPS use...
  10. ncbi Effect of transjugular intrahepatic portosystemic shunt on pulmonary gas exchange in patients with portal hypertension and hepatopulmonary syndrome
    Graciela Martinez-Palli
    Servei d Anestesiologia i Reanimacio Hospital Clinic, Institut d Investigacions Biomediques August Pi i Sunyer IDIBAPS, Universitat de Barcelona, Barcelona, Spain
    World J Gastroenterol 11:6858-62. 2005
    ..To assess the impact of transjugular intrahepatic portosystemic shunt (TIPS) on pulmonary gas exchange and to evaluate the use of TIPS for the treatment of hepatopulmonary syndrome ( HPS )...
  11. ncbi Serum bilirubin and early mortality after transjugular intrahepatic portosystemic shunts: results of a multivariate analysis
    Dheeraj K Rajan
    Division of Vascular and Interventional Radiology, Department of Medical Imaging, Toronto General Hospital University of Toronto, Toronto, ON, Canada
    J Vasc Interv Radiol 13:155-61. 2002
    ....
  12. ncbi Treatment of stomal variceal hemorrhage with TIPS: case report and review of the literature
    R K Ryu
    Section of Vascular and Interventional Radiology, Northwestern Memorial Hospital, Feinberg 4 710, 251 East Huron, Chicago, IL 60611, USA
    Cardiovasc Intervent Radiol 23:301-3. 2000
    ..Although several treatment options have been reported for this entity we believe that TIPS offers minimally invasive and definitive treatment...
  13. pmc Diastolic dysfunction is associated with poor survival in patients with cirrhosis with transjugular intrahepatic portosystemic shunt
    Massimo Cazzaniga
    Department of Internal Medicine, IRCCS Policlinico San Donato, University of Milan, Via Morandi 30, 20097 San Donato Milanese, Milano, Italy
    Gut 56:869-75. 2007
    ..Accurate prediction of the outcome of patients treated with TIPS is important, because some patients have very short survival. Diastolic dysfunction is frequently observed in patients with cirrhosis...
  14. ncbi MELD score as a predictor of early death in patients undergoing elective transjugular intrahepatic portosystemic shunt (TIPS) procedures
    Aaron Montgomery
    Section of Cardiovascular and Special Interventions, Department of Radiology, The University of Texas Health Sciences Center at San Antonio, Mail Code 7880, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
    Cardiovasc Intervent Radiol 28:307-12. 2005
    ..To Evaluate the MELD score as a predictor of 30-day mortality in patients undergoing elective TIPS procedures...
  15. ncbi Bleeding ectopic varices--treatment with transjugular intrahepatic porto-systemic shunt (TIPS) and embolisation
    Marcello Vangeli
    Liver Transplantation and Hepatobiliary Unit, Royal Free Hospital and NHS Hampstead Trust, London, UK
    J Hepatol 41:560-6. 2004
    ..Bleeding ectopic varices due to cirrhosis can be difficult to manage. We report our experience of uncontrolled bleeding from ectopic varices treated with transjugular intrahepatic porto-systemic shunt (TIPS)...
  16. ncbi Use of the Amplatzer Vascular Plug for embolization of a large retroperitoneal shunt during transjugular intrahepatic portosystemic shunt creation for gastric variceal bleeding
    Jonathan Kessler
    Department of Radiology, University of Pennsylvania Medical Center, 3400 Spruce Street, 1 Silverstein, Philadelphia, Pennsylvania 19104, USA
    J Vasc Interv Radiol 17:135-40. 2006
    ..Two Amplatzer Vascular Plugs and two platinum coils were used to occlude the shunt rapidly and completely...
  17. ncbi Transjugular intrahepatic portosystemic shunt for acute variceal bleeding in patients with viral liver cirrhosis: predictors of early mortality
    Chang Jin Yoon
    Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, 28 Yongon Dong, Chongno Gu, Seoul 110 774, South Korea
    AJR Am J Roentgenol 185:885-9. 2005
    ..The purpose of our study was to assess the predictors of early mortality after the creation of transjugular intrahepatic portosystemic shunts (TIPS) for acute variceal bleeding in patients with viral liver cirrhosis...
  18. ncbi Transjugular intrahepatic porto-systemic shunt and variceal embolisation in the management of bleeding stomal varices
    Bassam Alkari
    Department of Surgery, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK
    Int J Colorectal Dis 20:457-62. 2005
    ..Bleeding from stomal varices is uncommon. Local measures to control the bleeding offer short-lived control. Our experience with transjugular intrahepatic porto-systemic shunt (TIPS) and variceal embolisation is presented and appraised...
  19. ncbi Transjugular intrahepatic portosystemic shunt, mechanical aspiration thrombectomy, and direct thrombolysis in the treatment of acute portal and superior mesenteric vein thrombosis
    Carlo Ferro
    Department of Diagnostic and Interventional Radiology, San Martino University Hospital, Largo Rosanna Benzi 10, 16132 Genoa, Italy
    Cardiovasc Intervent Radiol 30:1070-4. 2007
    ..TIPS, mechanical aspiration thrombectomy, and direct thrombolysis together are promising endovascular techniques for the treatment of symptomatic acute PSMVT...
  20. ncbi Transjugular intrahepatic portasystemic shunt vs surgical shunt in good-risk cirrhotic patients: a case-control comparison
    W S Helton
    Providence Seattle Medical Center, 500 16th Ave, Seattle, WA 98124, USA
    Arch Surg 136:17-20. 2001
    ..surgical shunt is more effective, more durable, and less costly than angiographic shunt (transjugular intrahepatic portasystemic shunt [TIPS]). DESIGN: Retrospective case-control study...
  21. ncbi Stent graft in TIPS: technical and procedural aspects
    F Fanelli
    Dipartimento di Scienze Radiologiche, Universita di Roma La Sapienza, Viale Regina Elena 324, I 00161, Rome, Italy
    Radiol Med 111:709-23. 2006
    ..8%. However the use of the stentgraft is correlate with a high rate of hepatic hencefalopathy (46.6 %). In case of hepatic hencefalopathy refractory to the conventional medical therapy, TIPS reduction should be performed...
  22. ncbi Prospective evaluation of a clinical score for 60-day mortality after transjugular intrahepatic portosystemic stent-shunt: Bonn TIPSS early mortality analysis
    Karl August Brensing
    Department of Internal Medicine I, University of Bonn, Sigmund Freud Strasse 25, 53105 Bonn, Germany
    Eur J Gastroenterol Hepatol 14:723-31. 2002
    ..Transjugular intrahepatic portosystemic stent-shunt (TIPSS) is increasingly used to treat complications of portal hypertension, but proven tools for risk assessment of early mortality are lacking...
  23. ncbi Transjugular intrahepatic portosystemic shunt versus endoscopic therapy: randomized trials for secondary prophylaxis of variceal bleeding: an updated meta-analysis
    A K Burroughs
    Scand J Gastroenterol 37:249-52. 2002
  24. ncbi Modifications of cardiac function in cirrhotic patients treated with transjugular intrahepatic portosystemic shunt (TIPS)
    Manuela Merli
    Department of Clinical Medicine, University of Rome La Sapienza, Italy
    Am J Gastroenterol 97:142-8. 2002
    ..We investigated cardiac function before and 1, 3, 6, and 12 months after the TIPS procedure in cirrhotic patients...
  25. ncbi Comparison of MELD, Child-Pugh, and Emory model for the prediction of survival in patients undergoing transjugular intrahepatic portosystemic shunting
    Michael Schepke
    Department of Internal Medicine I, University of Bonn, Bonn, Germany
    Am J Gastroenterol 98:1167-74. 2003
    ..We therefore compared the prognostic accuracy of the different models, including the Child-Pugh score, in an unselected cohort of TIPS patients followed long-term...
  26. pmc Transcaval TIPS in patients with failed revision of occluded previous TIPS
    C K Seong
    Department of Radiology, Kyungpook National University School of Medicine, Daegu, Korea
    Korean J Radiol 2:204-9. 2001
    ..To determine the feasibility of transcaval transjugular intrahepatic portosystemic shunt (TIPS) in patients with occluded previous TIPS...
  27. ncbi Differences in long-term survival after transjugular intrahepatic portosystemic shunt for refractory ascites and variceal bleed
    Fernando Membreno
    Department of Internal Medicine, The University of Texas Medical Branch of Galveston, Texas, USA
    J Gastroenterol Hepatol 20:474-81. 2005
    ..To compare the survival after transjugular intrahepatic portosystemic shunt (TIPS) for refractory ascites and variceal bleed, and to identify the factors predictive of survival...
  28. ncbi Transjugular intrahepatic portosystemic shunt in Vienna--a decade later
    Bernhard Angermayr
    Department of Internal Medicine IV, University of Vienna, Vienna, Austria
    Wien Klin Wochenschr 116:608-13. 2004
    ....
  29. ncbi [Variceal hemorrhage: primary and secondary prophylaxis]
    T Sauerbruch
    Medizinische Universitätsklinik und Poliklinik I, Allgemeine Innere Medizin, Bonn
    Dtsch Med Wochenschr 129:S68-70. 2004
  30. pmc H-graft portacaval shunts versus TIPS: ten-year follow-up of a randomized trial with comparison to predicted survivals
    Alexander S Rosemurgy
    Department of Surgery, University of South Florida College of Medicine Tampa, FL 33601, USA
    Ann Surg 241:238-46. 2005
    ..To report long-term outcome of patients undergoing prosthetic 8-mm H-graft portacaval shunts (HGPCS) or TIPS and to compare actual with predicted survival data...
  31. ncbi A new era for transjugular intrahepatic portosystemic shunts?
    Richard R Saxon
    San Diego Vascular Institute, Diagnostic Imaging and Interventional Radiology, North County Radiology Medical Group, Tri City Medical Center, 4002 Vista Way, Oceanside, California 92056, USA
    J Vasc Interv Radiol 15:217-9. 2004
  32. ncbi Fundal variceal bleeding after correction of portal hypertension in patients with cirrhosis
    Mary E Rinella
    Northwestern University Medical School, Division of Hepatology, Chicago, Illinois 60611, USA
    Gastrointest Endosc 58:122-7. 2003
    ..Methods and Observations: Five patients with cirrhosis evaluated for upper GI hemorrhage from fundal varices underwent upper endoscopy followed by angiography, which documented a spontaneous splenogastrorenal shunt...
  33. pmc Balloon-occluded retrograde transvenous obliteration for gastric variceal bleeding: its feasibility compared with transjugular intrahepatic portosystemic shunt
    Young Ho Choi
    Department of Radiology, Seoul City Boramae Hospital, Seoul, Korea
    Korean J Radiol 4:109-16. 2003
    ..Changes in the Child-Pugh score before and after each procedure in each group were statistically analyzed by means of Wilcoxon's signed rank test...
  34. ncbi Transjugular intrahepatic portosystemic shunt in five children with cystic fibrosis: long-term results
    Oldrich Pozler
    University Hospital, Charles University, Dept of Pediatrics, 500 05 Hradec Kralove, Czech Republic
    Hepatogastroenterology 50:1111-4. 2003
    ..The aim of this study was to report results of TIPS (transjugular intrahepatic portosystemic shunt) in 5 consecutive children with cystic fibrosis and monitor long-term follow-up results...
  35. ncbi Prognostic impact of renal impairment and sodium imbalance in patients undergoing transjugular intrahepatic portosystemic shunting for the prevention of variceal rebleeding
    Michael Schepke
    Department of Internal Medicine I, University of Bonn, Bonn, Germany
    Digestion 67:146-53. 2003
    ....
  36. ncbi Doppler evaluation of transjugular intrahepatic portosystemic shunts
    William D Middleton
    Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis 63110, Missouri, USA
    Ultrasound Q 19:56-70; quiz 108 - 10. 2003
    ..Many studies have confirmed that Doppler sonography is a valuable, noninvasive means of detecting stent malfunction, although the criteria vary somewhat at different institutions...
  37. ncbi Complications of cirrhosis
    Christian Mendez
    Division of Gastroenterology Hepatology, Department of Medicine, University of Louisville, Louisville, Kentucky 40292, USA
    J Ky Med Assoc 101:403-14. 2003
  38. ncbi Doppler ultrasound evaluation of transjugular intrahepatic portosystemic shunt function: pitfalls and artifacts
    Ronald H Wachsberg
    Department of Radiology, University Hospital, Newark, NJ 07103, USA
    Ultrasound Q 19:139-48. 2003
    ..In this article the author discusses and illustrates the spectrum of pitfalls that may be encountered during Doppler evaluation of TIPS function...
  39. ncbi Portal hypertension: from Eck's fistula to TIPS
    Stuart J Knechtle
    Division of Transplantation, Department of Surgery, University of Wisconsin Medical School, Madison, WI, USA
    Ann Surg 238:S49-55. 2003
    ..A multidisciplinary, integrated approach to this clinical problem is needed to assure optimal outcomes...
  40. ncbi Management of gastrointestinal bleeding in patients with cirrhosis of the liver
    Jaime Bosch
    Liver Unit, Hospital Clinic, University of Barcelona, Spain
    Semin Hematol 41:8-12. 2004
    ..Specific sections on gastric varices and portal hypertensive gastropathy are included...
  41. ncbi Selection criteria for patients undergoing transjugular intrahepatic portosystemic shunt procedures: current status
    Hector Ferral
    Department of Radiology, Rush University Medical Center, 1725 West Harrison Street, Suite 456, Chicago, Illinois 60612 3833, USA
    J Vasc Interv Radiol 16:449-55. 2005
    ....
  42. ncbi [What's left for surgical treatment of portal hypertension in cirrhosis patients?]
    François René Pruvot
    Service de chirurgie digestive et transplantation, Hopital Huriez, CHU, Lille
    Gastroenterol Clin Biol 27:1013-20. 2003
  43. ncbi [Therapy of complications of hepatic cirrhosis]
    U Tox
    Schwerpunkt Gastroenterologie und Hepatologie, Universitat zu Koln, Koln
    Praxis (Bern 1994) 94:727-33. 2005
    ..Hepatorenal syndrome is characterized by a poor prognosis. Therefore, liver transplantation should be considered in appropriate patients...
  44. ncbi [Rupture of esophageal varices]
    Jean Pierre Vinel
    Hépato Gastroentérologie, Fédération Digestive, CHU Purpan INSERM U531, 31059 Toulouse
    Gastroenterol Clin Biol 30:875-9. 2006
  45. ncbi Cirrhotic portal hypertension: current and future medical therapy for primary and secondary prevention of variceal bleeding
    W Laleman
    Department of Hepatology, University Hospital Gasthuisberg, K U Leuven, B 3000 Leuven, Belgium
    Minerva Med 97:325-45. 2006
    ..This review covers current and future developments in the treatment of PHT with regard to primary and secondary prophylaxis...
  46. ncbi The use of transjugular intrahepatic portosystemic stent shunt in the management of acute oesophageal variceal haemorrhage
    Norma C McAvoy
    Department of Hepatology and Scottish Liver Transplant Unit, Royal Infirmary of Edinburgh, Edinburgh, UK
    Eur J Gastroenterol Hepatol 18:1135-41. 2006
    ..A management algorithm is proposed. The timing of intervention is emphasized and the importance of admission to specialized centres. Regional protocols are probably essential for the latter to be organized effectively...
  47. ncbi Transjugular intrahepatic portosystemic shunt--role in treating intractable variceal bleeding, ascites, and hepatic hydrothorax
    Jeanne M LaBerge
    Division of Interventional Radiology, Department of Radiology, University of California San Francisco, M 361 505 Parnassus Avenue, Box 0628, San Francisco, CA 94143, USA
    Clin Liver Dis 10:583-98, ix. 2006
    ....
  48. ncbi Safety and efficacy of TIPS in patients with hemophilia and cirrhosis
    Joshua P Beirne
    Department of Medicine, University of California San Francisco, 505 Parnassus Ave, Box 0628, San Francisco, CA 94143 0628, USA
    J Vasc Interv Radiol 18:309-12. 2007
    ..Outcomes after TIPS placement appear to be comparable to those in patients without hemophilia...
  49. ncbi [Prevention and treatment of esophageal variceal bleeding]
    Zsuzsanna Vitalis
    Orv Hetil 147:2455-63. 2006
    ..If necessary, drug administration should be complemented with varix ligation or sclerotherapy. In case of inefficiency TIPS implantation or liver transplantation must be considered...
  50. ncbi Prevention of recurrent esophageal variceal hemorrhage: review and current recommendations
    David Kravetz
    San Diego Veterans Affairs Medical Center, University of California at San Diego, San Diego, CA 92161, USA
    J Clin Gastroenterol 41:S318-22. 2007
    ..The only difference observed was the higher rate of reintervention observed in the TIPS group to maintain his patency...
  51. ncbi Emergent treatment of variceal bleeding in two infants
    A Park
    Vascular and Interventional Radiology, University of Michigan Hospital, Ann Arbor, Michigan, USA
    Acta Radiol 49:951-4. 2008
    ..Following percutaneous transhepatic embolization of the varices, successful bleeding control was achieved in both patients...
  52. pmc Transjugular intrahepatic portosystemic stent shunt (TIPSS) modification in the management of post-TIPSS refractory hepatic encephalopathy
    N Kochar
    Department of Hepatology, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SU, UK
    Gut 55:1617-23. 2006
    ..In 5%, this can be refractory to optimal medical treatment and may require shunt modification. The efficacy of shunt modification has been poorly studied...
  53. ncbi A patient with portal hypertension and blindness after transjugular intrahepatic portosystemic shunt
    Beate Appenrodt
    Department of Internal Medicine I, University of Bonn, Bonn, Germany
    Eur J Gastroenterol Hepatol 18:447-9. 2006
    ..The present case report shows a very rare but important complication after TIPS implantation. To avoid this complication it is recommended to perform echocardiography before all TIPS placements...
  54. ncbi Pharmacologic therapy for gastrointestinal bleeding due to portal hypertension and esophageal varices
    Don C Rockey
    Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390 8887, USA
    Curr Gastroenterol Rep 8:7-13. 2006
    ..For primary and secondary prevention of esophageal variceal hemorrhage, beta-blockers remain the mainstay therapy...
  55. ncbi Comparison of transjugular intrahepatic portosystemic shunt dysfunction in PTFE-covered stent-grafts versus bare stents
    José Barrio
    Department of Gastroenterology and Hepatology, Hospital General Universitario Gregorio Maranon, C Dr Esquerdo 46, Madrid, 28007, Spain
    Eur J Radiol 55:120-4. 2005
    ....
  56. ncbi Transjugular intrahepatic portosystemic shunts: adjunctive embolotherapy of gastroesophageal collateral vessels in the prevention of variceal rebleeding
    I Kaare Tesdal
    Department of Clinical Radiology, Universitatsklinikum Mannheim, Germany
    Radiology 236:360-7. 2005
    ....
  57. ncbi [Surgical treatment of portal hypertension]
    M Wolff
    Klinik und Poliklinik für Allgemein, Viszeral, Thorax und Gefasschirurgie, Rheinische Friedrich Wilhelms Universitat, Bonn
    Zentralbl Chir 130:238-45. 2005
    ..Gastroesophageal devascularization and other direct variceal ablative procedures should be restricted to treat endoscopic therapy failures without shuntable portal tributaries...
  58. ncbi [Transjugular intrahepatic portosystemic stent shunt: indications and long-term outcome]
    M Wettstein
    Gastroenterologie, Universitatsklinikum Dusseldorf
    Zentralbl Chir 130:246-9. 2005
    ..Major complications are the manifestation or worsening of hepatic encephalopathy. Recent studies using PTFE covered stents have shown lower stenosis rates and a trend towards prolonged survival...
  59. ncbi Current management of portal hypertension
    Andrew S Wright
    Department of Surgery, University of Wisconsin Medical School, Madison, Wisconsin 53792, USA
    J Gastrointest Surg 9:992-1005. 2005
    ..Recommendations and a treatment algorithm are provided, taking into account both the etiology and the manifestations of portal hypertension...
  60. ncbi Improved clinical outcome with transjugular intrahepatic portosystemic stent-shunt utilizing polytetrafluoroethylene-covered stents
    Dhiraj Tripathi
    Department of Hepatology, Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK
    Eur J Gastroenterol Hepatol 18:225-32. 2006
    ..Newer covered stents appear to have improved patency. This large study aimed to assess the shunt function and clinical efficacy of polytetrafluoroethylene-covered stents in a single centre...
  61. ncbi [Budd-Chiari syndrome in a patient with paroxysmal nocturnal haemoglobinuria]
    Z Balta
    Medizinische Klinik und Poliklinik I, Allgemeine Innere Medizin, Bonn
    Dtsch Med Wochenschr 130:2257-60. 2005
    ..One year before the patient underwent radical retropubic prostatectomy for a localized prostate cancer. Shortly after this intervention he developed ascites...
  62. ncbi Usefulness of transjugular intrahepatic portosystemic shunt in the management of bleeding ectopic varices in cirrhotic patients
    V Vidal
    Department of Radiology, CHUM Saint Luc Hospital, 1058, Saint Denis Street, Montreal, QC, H2X 3J4, Canada
    Cardiovasc Intervent Radiol 29:216-9. 2006
    ..To evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in the control of bleeding from ectopic varices...
  63. pmc Transjugular intrahepatic portosystemic shunt versus H-graft portacaval shunt in the management of bleeding varices: a cost-benefit analysis
    Marcelo Enne
    Ann Surg 243:139-40; author reply 140. 2006
  64. ncbi [Transjugular intrahepatic portosystemic shunt (TIPS). Therapeutic alternative in refractory ascites and varicose bleeding]
    Marie Olin
    Helsingborgs lasarett, Helsingborg
    Lakartidningen 105:2490-4. 2008
  65. ncbi Management of variceal bleeding
    Rachael Harry
    Institute of Liver Studies, Kings College Hospital, London, England, UK
    Curr Opin Crit Care 8:164-70. 2002
    ..Secondary prophylaxis to prevent rebleeding is often instituted in the ICU and is vital to prevent recurrence of this life-threatening complication...
  66. ncbi [TIPS - Transjugular intrahepatic portosystemic shunt. A review]
    G Carreiro
    , Universidade Federal do Rio de Janeiro-UFRJ-Hospital Clementino Fraga Filho, Rio de Janeiro, RJ
    Arq Gastroenterol 38:69-80. 2001
    ..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...
  67. ncbi Impact of transjugular intrahepatic portosystemic stent-shunt for secondary prophylaxis of oesophageal variceal haemorrhage: a single-centre study over an 11-year period
    Rajiv Jalan
    Liver Unit, Royal Infirmary Edinburg, UK
    Eur J Gastroenterol Hepatol 14:615-26. 2002
    ....
  68. pmc Modern management of oesophageal varices
    P J Gow
    Department of Gastroenterology, Oxford Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK
    Postgrad Med J 77:75-81. 2001
    ..This article reviews the literature regarding therapies available in the treatment of haemorrhage from oesophageal varices and provides guidelines to aid the physicians in clinical decision making...
  69. ncbi [TIPS--transjugular intrahepatic portosystemic shunt. Experiences from a recently started center]
    Lone Bording Astrup
    Arhus Universitetshospital, Arhus Kommunehospital, medicinsk afdeling V og radiologisk afdeling R
    Ugeskr Laeger 165:443-6. 2003
    ..Seven out of 9 patients with refractory ascites no longer required paracentesis after six months. The cumulative survival for the whole group was 81% after one year and 62% after three years...
  70. ncbi [Transjugular intrahepatic portosystemic shunt (TIPS) for the treatment of complications of portal hypertension in patients with liver cirrhosis]
    Henning Grønbaek
    Arhus Universitetshospital, Arhus Kommunehospital, medicinsk afdeling V og radiologisk afdeling R
    Ugeskr Laeger 165:439-42. 2003
    ..Absolute and relative contraindications are severe hepatic failure, a history of hepatic encephalopathy, infections, respiratory failure, and non-hepatic renal insufficiency...
  71. ncbi [TIPSS]
    J C Garcia-Pagan
    Nefrologia 22:47-51. 2002
  72. ncbi Long-term results and quality of life in patients treated with transjugular intrahepatic portosystemic shunts
    Zhen W Zhuang
    Department of Radiology, Dartmouth Hitchcock Medical Center, One Medical Center Dr, Lebanon, NH 03756, USA
    AJR Am J Roentgenol 179:1597-603. 2002
    ..The purpose of our study was to determine long-term survival, shunt patency, and quality of life in patients after creation of a transjugular intrahepatic portosystemic shunt (TIPS)...
  73. ncbi Transjugular intrahepatic portosystemic shunt in the treatment of portal hypertension using memotherm stents: a prospective multicenter study
    Dirk Domagk
    Department of Medicine B, University of Muenster, Muenster, Germany
    Cardiovasc Intervent Radiol 25:506-12. 2002
    ....
  74. ncbi Liver transplantation in patients with liver cirrhosis and esophageal bleeding
    Christian Hillert
    Transplantation Center, Department of Hepatobiliary Surgery and Transplantation, University Hospital Hamburg, Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
    Langenbecks Arch Surg 388:150-4. 2003
    ..Uncontrolled hemorrhage from esophageal varices is one of the most devastating complications of portal hypertension in patients with advanced cirrhosis...
  75. ncbi Analysis of Model for End-Stage Liver Disease (MELD) score in a liver transplantation waiting list
    B H Ferraz-Neto
    Figado HIAE, Albert Einstein Jewish Hospital, Av Albert Einstein 627 701, 05652 900 São Paulo SP, Brazil
    Transplant Proc 39:2511-3. 2007
    ..The aim of this study was to analyze the MELD scores of patients on the liver waiting list for comparisons between transplanted patients...
  76. ncbi Treatment of gastropathy and gastric antral vascular ectasia in patients with portal hypertension
    Cristina Ripoll
    Guadalupe Garcia Tsao, MD Digestive Diseases Section, Yale University School of Medicine, 333 Cedar Street 1080 LMP, New Haven, CT 06510, USA
    Curr Treat Options Gastroenterol 10:483-94. 2007
    ..Preliminary data suggest that cryotherapy may be a reasonable option for diffuse GAVE lesions. Neither beta-blockers nor TIPS reduces the bleeding risk in patients with GAVE and thus should not be used in this setting...
  77. ncbi Midodrine and octreotide in treatment of cirrhosis-related hemodynamic complications
    Rakhi Karwa
    Harrison School of Pharmacy, Auburn University, AL, USA
    Ann Pharmacother 43:692-9. 2009
    ..To review studies evaluating the use of midodrine and octreotide in hemodynamic complications of cirrhosis, including ascites and hepatorenal syndrome...
  78. ncbi Radiation doses in interventional radiology procedures: the RAD-IR study: part II: skin dose
    Donald L Miller
    Department of Radiology, National Naval Medical Center, Bethesda, MD 20889 5600, USA
    J Vasc Interv Radiol 14:977-90. 2003
    ....
  79. ncbi Comparison of hepatic damage from direct injections of iodinated contrast agents and carbon dioxide
    W C Culp
    University of Florida Veterans Administration Medical Center, Gainesville, USA
    J Vasc Interv Radiol 10:1265-70. 1999
    ....
  80. ncbi [Use of direct portal vein puncture portography with modified TIPS treatment in patients with portal hypertension and gastro-esophageal varices bleeding]
    Chang Qing Li
    Department of Radiology, Ditan Hospital, Beijing 100011, China
    Zhonghua Gan Zang Bing Za Zhi 13:403-6. 2005
    ..To explore a better procedure for transjugular intrahepatic portosystemic shunt (TIPS) in order to improve its safety and to extend its indications...
  81. ncbi Endotipsitis-persistent infection of transjugular intrahepatic portosystemic shunt: pathogenesis, clinical features and management
    Meir Mizrahi
    Liver Unit, Division of Medicine, Jerusalem, Israel
    Liver Int 30:175-83. 2010
    ..The aim of this review was to describe the definition, clinical course, diagnosis, pathogenesis, microbiology, treatment and outcome of endotipsitis...
  82. ncbi Early and long-term clinical and radiological follow-up results of expanded-polytetrafluoroethylene-covered stent-grafts for transjugular intrahepatic portosystemic shunt procedures
    Geert Maleux
    Department of Radiology, University Hospitals Gasthuisberg, Herestraat 49, Leuven, Belgium
    Eur Radiol 14:1842-50. 2004
    ..The incidence of TIPS-induced hepatic encephalopathy is acceptable...
  83. ncbi The use of carbon dioxide wedged hepatic venography to identify the portal vein: comparison with direct catheter portography with iodinated contrast medium and analysis of predictive factors influencing level of opacification
    Geert Maleux
    Department of Radiology, University Hospitals Gasthuisberg, Herestraat 49, B 3000 Leuven, Belgium
    J Vasc Interv Radiol 17:1771-9. 2006
    ..Additionally, the predictive value of several parameters that potentially influence the level of portal vein opacification by CO(2) WHV was analyzed...
  84. ncbi Transvenous extrahepatic portacaval shunt: feasibility study in a Swine model
    Michael J Wallace
    John S Dunn Center for Radiological Sciences, Section of Vascular and Interventional Radiology, Department of Diagnostic Radiology, University of Texas M D Anderson Cancer Center, Houston, 77030 4009, USA
    Radiology 228:119-25. 2003
    ....
  85. ncbi [First experience with transjugular intrahepatic porto-systemic shunt (TIPS)]
    Istvan Lazar
    B A Z Megyei Kórház Röntgen Intézet, 3501 Miskolc, Pf 188
    Magy Seb 55:9-15. 2002
    ..Our short follow-up time (average 6 months, longest 21 months) does not allow correct comparison with the 2-years survival of severe cirrhotic patients, but according to the literature TIPS does not change it significantly...
  86. ncbi Ascites and spontaneous bacterial peritonitis: an Asian perspective
    Jung Min Lee
    Department of Internal Medicine, Brain Korea 21 Project for Medical Science, Seoul, South Korea
    J Gastroenterol Hepatol 24:1494-503. 2009
    ..Further study, particularly in Asia where hepatitis B virus-related cirrhosis is predominant, is warranted to improve the clinical outcome...
  87. ncbi [The retrospective study of transjugular intrahepatic portosystemic shunt with covered or uncovered stents in patients with portal hypertension]
    Xing Jiang Wu
    Department of General Surgery, Nanjing Jin Ling Hospital, Nanjing 210002, China
    Zhonghua Wai Ke Za Zhi 48:83-7. 2010
    ..To retrospectively compare the clinical outcome in patients with portal hypertension treated with transjugular intrahepatic portosystemic shunt (TIPS) using Fluency stent-graft (PTFE-covered stents) or bare stents...
  88. ncbi A comparison of paracentesis and transjugular intrahepatic portosystemic shunting in patients with ascites
    M Rossle
    Medizinische Klinik II, Albrecht Ludwigs Universität, Department of Gastroenterology, Freiburg, Germany
    N Engl J Med 342:1701-7. 2000
    ..However, the benefit of this procedure as compared with that of large-volume paracentesis is uncertain...
  89. ncbi Polytetrafluoroethylene-covered nitinol stent-graft for transjugular intrahepatic portosystemic shunt creation: 3-year experience
    Plinio Rossi
    Department of Radiological Sciences, Policlinico Umberto I, Viale Regina Elena 324, 00161 Rome, Italy
    Radiology 231:820-30. 2004
    ....
  90. ncbi Transjugular intrahepatic portosystemic shunt: current status
    Thomas D Boyer
    Department of Medicine, University of Arizona College of Medicine, Tucson, 85724, USA
    Gastroenterology 124:1700-10. 2003
    ..Despite the apparent efficacy of TIPS in many of these situations, its use should be limited to salvage therapy pending the publication of controlled trials showing it is a better treatment than other forms of therapy...
  91. ncbi Hepatorenal syndrome
    Pere Gines
    Liver Unit, Hospital Cli nic, Institut d Investigacions Biomèdiques August Pi Sunyer, University of Barcelona School of Medicine, Barcelona, Catalunya, Spain
    Lancet 362:1819-27. 2003
    ..Although these findings need to be confirmed, these two strategies represent innovative approaches to lower the frequency of HRS in clinical practice...
  92. ncbi Influence of portal pressure change on intestinal permeability in patients with portal hypertension
    Wei Hua Xu
    Department of General Surgery, Jinling Hospital, Nanjing 210002, China
    Hepatobiliary Pancreat Dis Int 1:510-4. 2002
    ..To investigate intestinal permeability in patients with portal hypertension and its relationship with portal pressure...
  93. ncbi Right atrial pressure is not adequate to calculate portal pressure gradient in cirrhosis: a clinical-hemodynamic correlation study
    Vincenzo La Mura
    Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d Investigacions Biomediques August Pi i Sunyer, University of Barcelona and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas CIBERehd, Barcelona, Spain
    Hepatology 51:2108-16. 2010
    ..In our TIPS patients, 20% had a PCG < or =12 mm Hg and a PAG >12 mm Hg, which may have induced unnecessary overdilation of the TIPS...
  94. ncbi Main portal vein access in transjugular intrahepatic portosystemic shunt procedures: use of three-dimensional ultrasound to ensure safety
    Steven C Rose
    Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103 8756, USA
    J Vasc Interv Radiol 13:267-73. 2002
    ....
  95. ncbi Two-stage total hepatectomy and liver transplantation for acute deterioration of chronic liver disease: a new bridge to transplantation
    Michael J Guirl
    Department of Internal Medicine, Division of Gastroenterology, Baylor University Medical Center, Dallas, TX 75246, USA
    Liver Transpl 10:564-70. 2004
    ..Two-stage total hepatectomy and liver transplantation may be a life-saving procedure in highly selected cirrhotic patients with acute hepatic decompensation and multiorgan dysfunction...
  96. ncbi TIPS-related hepatic encephalopathy: management options with novel endovascular techniques
    David C Madoff
    Division of Diagnostic Imaging, Section of Vascular and Interventional Radiology, University of Texas M D Anderson Cancer Center, 1515 Holcombe Blvd, Unit 325, Houston, TX 77030 4009, USA
    Radiographics 24:21-36; discussion 36-7. 2004
    ..Further research is necessary to improve our understanding of TIPS-related hepatic encephalopathy so that newer, less invasive and safer procedures can be developed to treat this difficult clinical problem...
  97. ncbi Improved quality of life in patients with refractory or recidivant ascites after insertion of transjugular intrahepatic portosystemic shunts
    Veit Gulberg
    Department of Medicine II, Klinikum of the University of Munich Grosshadern, Germany
    Digestion 66:127-30. 2002
    ..Therefore, the aim of this study was to determine the effect of TIPS on the QOL in cirrhotic patients with refractory or recidivant ascites...
  98. ncbi Use of a tunnelled pleural catheter for the management of refractory hepatic hydrothorax: a new therapeutic option
    Pascale Mercky
    Hopital de la Conception, Marseille, France
    Respiration 80:348-52. 2010
    ..Herein, we present this novel potential indication of the indwelling pleural catheter and illustrate the successful clinical outcome...
  99. pmc Surgical management of anatomical variations of the right lobe in living donor liver transplantation
    A Marcos
    Division of Transplantation, Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia 23298 0057, USA
    Ann Surg 231:824-31. 2000
    ..To review the anatomical variations of the right lobe encountered in 40 living liver donors, describe the surgical management of these variations, and summarize the results of these procedures...
  100. ncbi Use of splenic artery embolization to relieve tense ascites following liver transplantation in a patient with paroxysmal nocturnal hemoglobinuria
    Charissa Y Chang
    Recanati Miller Transplant Institute, Mount Sinai Hospital, Mount Sinai School of Medicine, New York, NY, USA
    Liver Transpl 13:1532-7. 2007
    ....
  101. pmc Transjugular intrahepatic portosystemic shunt (TIPS) versus endoscopic variceal ligation in the prevention of variceal rebleeding in patients with cirrhosis: a randomised trial
    G Pomier-Layrargues
    Liver Unit, Hopital Saint Luc, CHUM and Université de Montréal, 164, East René Lévesque Boulevard, Montreal, Quebec, Canada H2X 1P1
    Gut 48:390-6. 2001
    ..In this study we compared the two year survival and rebleeding rates in cirrhotic patients treated by either variceal band ligation or TIPS for variceal bleeding...

Research Grants8

  1. 3D Image Guided Endovascular Surgery
    Elizabeth Bullitt; Fiscal Year: 2006
    ..Indeed, the methods to be developed under this proposal have the potential to change how endovascular procedures are performed throughout the body. ..
  2. FACTORS IN THE PREVENTION OF TOXIC LIVER INJURY
    Thomas Boyer; Fiscal Year: 2008
    ..The studies will clarify why expression of certain proteins fall during the acute phase response. ..
  3. MULTICENTER RANDOMIZED TRIAL OF DSRS VERSUS TIPS
    John Henderson; Fiscal Year: 2004
    ..The extension of this trial, will provide the most comprehensive and longest follow-up for these two shunt procedures for control of variceal bleeding. ..
  4. Biliary Microlithiasis in Alcohol Induced Pancreatitis
    Arun Sanyal; Fiscal Year: 2007
    ..The long-term goal is to use data from this R21 proposal to develop a RO1 proposal about a large scale phase III clinical trial of UDCA for alcohol-induced pancreatitis. [unreadable] [unreadable] [unreadable]..
  5. The CNS and cirrhosis:psychobiological approaches
    Charmaine Stewart; Fiscal Year: 2006
    ..Additionally, the proposed studies will be guided by a team of mentors and sponsors and supplemented by a didactic curriculum, all to lay the foundation for eventual independent clinical investigator status. ..
  6. HCV-HIV Coinfection: Impact of Immune Dysfunction
    Richard Sterling; Fiscal Year: 2007
    ..The K-23 award will protect this candidates time and help him mature into a senior investigator in Hepatology. ..
  7. Relationship of metabolic abnormalities to hepatic steatosis in HIV
    Richard Sterling; Fiscal Year: 2008
    ..If our hypothesis is correct, this work could result in a dramatic change in the long-term care of the over 1 million HIV infected individuals in the US. [unreadable] [unreadable]..
  8. Empirical Determination of Sufficiently Similiar Complex Mixtures
    Chris Gennings; Fiscal Year: 2009
    ..The funded project will further develop/characterize a method of determining sufficient similarity in dose-responsiveness for mixtures with many components. ..