Transjugular intrahepatic portosystemic shunt (TIPS): current indications and strategies to improve the outcomes.
Intern Emerg Med
; 15(1): 37-48, 2020 01.
Article
en En
| MEDLINE
| ID: mdl-31919780
ABSTRACT
Transjugular intrahepatic portosystemic shunt (TIPS) represents a very effective treatment of complications of portal hypertension. Established indications to TIPS in cirrhotic patients include portal hypertensive bleeding and refractory ascites. Over the years additional indications have been proposed, such as the treatment of vascular disease of the liver, hepatic hydrothorax, hepatorenal syndrome and bleeding from ectopic varices. Indications under evaluation include treatment of portal hypertension prior to major abdominal surgery and treatment of portal vein thrombosis. In spite of these advances, there are still uncertainties regarding the appropriate workup for patients to be scheduled for TIPS. Moreover, prevention and management of post-TIPS complications including hepatic encephalopathy and heart failure are still suboptimal. These issues are particularly relevant considering aging in TIPS candidates in Western countries. Correct selection of patients is mandatory to prevent complications which may eventually frustrate the good hemodynamic results and worsen the patient's quality of life or even life expectancy. The possible role of small diameter TIPS to prevent post-procedural complications is discussed.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Derivación Portosistémica Intrahepática Transyugular
/
Hipertensión Portal
Límite:
Humans
Idioma:
En
Revista:
Intern Emerg Med
Asunto de la revista:
MEDICINA DE EMERGENCIA
/
MEDICINA INTERNA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Italia