Procedural and shunt-related complications and mortality of the transjugular intrahepatic portosystemic shunt (TIPSS).
Aliment Pharmacol Ther
; 44(10): 1051-1061, 2016 11.
Article
em En
| MEDLINE
| ID: mdl-27670147
ABSTRACT
BACKGROUND:
The implantation of a transjugular intrahepatic portosystemic shunt (TIPSS) is a complex angiographic procedure performed in patients with end-stage liver disease. Numerous case reports and narrative reviews have been published so far; however, studies systematically investigating procedural and shunt-related complications are lacking.AIM:
To systematically investigate complications and mortality occurring during the index hospital stay and the early (4-week) period after TIPSS implantation.METHODS:
The study includes 389 patients who received a TIPSS implantation between 2004 and 2014. Data were obtained from the clinical records and technical reports of the TIPSS implantation.RESULTS:
During the index hospital stay, procedure-related complications occurred in 42 patients (10.8%) with intraperitoneal bleeding in 8 patients (2.1%) and infections in 14 patients (3.6%). Shunt- and disease-related complications consisted of hepatic encephalopathy (1-year incidence 29%), non-procedural infections (8.7%) and acute hepatic decompensation (4.1%). Nine patients (2.3%) died during the index hospital stay from procedure-related (two patients, 0.5%), shunt-related (four patients, 1%) or disease-related causes (three patients, 0.8%). 23 patients (5.9%) died during 4 weeks after TIPSS implantation. The 1-year probability of survival was 67.7% and was negatively associated with severe hepatic encephalopathy and acute hepatic decompensation.CONCLUSIONS:
Except hepatic encephalopathy, severe procedure- and shunt-related complications are rare and early mortality is low.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Encefalopatia Hepática
/
Derivação Portossistêmica Transjugular Intra-Hepática
/
Doença Hepática Terminal
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Aliment Pharmacol Ther
Assunto da revista:
FARMACOLOGIA
/
GASTROENTEROLOGIA
/
TERAPIA POR MEDICAMENTOS
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Alemanha