The Pull-Through Technique for Recanalization of Transjugular Intrahepatic Portosystemic Shunt Dysfunction

Purpose. To evaluate the technical efficacy and safety of the pull-through technique in recanalization of transjugular intrahepatic portosystemic shunt (TIPS) when standard transjugular approach is inaccessible. Materials and Methods. A retrospective review of patients underwent TIPS revision via th...

Full description

Saved in:
Bibliographic Details
Main Authors: Si-liang Chen, Cheng-jiang Xiao, Shuai Wang, Si-yi Jin, Jian-bo Zhao
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2020/9150173
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832565973306048512
author Si-liang Chen
Cheng-jiang Xiao
Shuai Wang
Si-yi Jin
Jian-bo Zhao
author_facet Si-liang Chen
Cheng-jiang Xiao
Shuai Wang
Si-yi Jin
Jian-bo Zhao
author_sort Si-liang Chen
collection DOAJ
description Purpose. To evaluate the technical efficacy and safety of the pull-through technique in recanalization of transjugular intrahepatic portosystemic shunt (TIPS) when standard transjugular approach is inaccessible. Materials and Methods. A retrospective review of patients underwent TIPS revision via the pull-through technique was performed. Transhepatic directly punctured stent was conducted if the portal vein could not be accessed via standard transjugular approach. Technical success was defined by recanalization of shunt. Clinical success was defined as bleeding interruption and ascites regression without pharmacological support. All patients were followed up by clinical evaluation and Doppler ultrasound. Results. Between January 2010 and December 2016, a total of 63 patients underwent TIPS revision, and 14 of them could not be accessed via standard transjugular approaches owing to stenosis or occlusion of the hepatic vein. The pull-through technique was successful in 13 patients, and one patient underwent parallel TIPS. No procedure-related complication was observed. One patient died of liver failure one week after the procedure. During the follow-up, three patients developed hepatic encephalopathy, and one patient developed TIPS dysfunction again and experienced variceal bleeding. The primary patency rate after TIPS revision was 92% (11/12) at 12 months. Conclusion. The pull-through technique was effective and safe for recanalization of TIPS inaccessible via standard transjugular approach.
format Article
id doaj-art-15dc9ba4b81e4eceb27840e663aba08c
institution Kabale University
issn 1687-6121
1687-630X
language English
publishDate 2020-01-01
publisher Wiley
record_format Article
series Gastroenterology Research and Practice
spelling doaj-art-15dc9ba4b81e4eceb27840e663aba08c2025-02-03T01:05:23ZengWileyGastroenterology Research and Practice1687-61211687-630X2020-01-01202010.1155/2020/91501739150173The Pull-Through Technique for Recanalization of Transjugular Intrahepatic Portosystemic Shunt DysfunctionSi-liang Chen0Cheng-jiang Xiao1Shuai Wang2Si-yi Jin3Jian-bo Zhao4Department of Interventional Radiology, Guangdong Second Provincial General Hospital, Guangzhou, 510317 Guangdong, ChinaDepartment of Interventional Radiology, Guangdong Second Provincial General Hospital, Guangzhou, 510317 Guangdong, ChinaDepartment of Intensive Care Unit, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou, 510800 Guangdong, ChinaInternal Medicine Training Base, Guangdong Second Provincial General Hospital, Guangzhou, 510317 Guangdong, ChinaDivision of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515 Guangdong, ChinaPurpose. To evaluate the technical efficacy and safety of the pull-through technique in recanalization of transjugular intrahepatic portosystemic shunt (TIPS) when standard transjugular approach is inaccessible. Materials and Methods. A retrospective review of patients underwent TIPS revision via the pull-through technique was performed. Transhepatic directly punctured stent was conducted if the portal vein could not be accessed via standard transjugular approach. Technical success was defined by recanalization of shunt. Clinical success was defined as bleeding interruption and ascites regression without pharmacological support. All patients were followed up by clinical evaluation and Doppler ultrasound. Results. Between January 2010 and December 2016, a total of 63 patients underwent TIPS revision, and 14 of them could not be accessed via standard transjugular approaches owing to stenosis or occlusion of the hepatic vein. The pull-through technique was successful in 13 patients, and one patient underwent parallel TIPS. No procedure-related complication was observed. One patient died of liver failure one week after the procedure. During the follow-up, three patients developed hepatic encephalopathy, and one patient developed TIPS dysfunction again and experienced variceal bleeding. The primary patency rate after TIPS revision was 92% (11/12) at 12 months. Conclusion. The pull-through technique was effective and safe for recanalization of TIPS inaccessible via standard transjugular approach.http://dx.doi.org/10.1155/2020/9150173
spellingShingle Si-liang Chen
Cheng-jiang Xiao
Shuai Wang
Si-yi Jin
Jian-bo Zhao
The Pull-Through Technique for Recanalization of Transjugular Intrahepatic Portosystemic Shunt Dysfunction
Gastroenterology Research and Practice
title The Pull-Through Technique for Recanalization of Transjugular Intrahepatic Portosystemic Shunt Dysfunction
title_full The Pull-Through Technique for Recanalization of Transjugular Intrahepatic Portosystemic Shunt Dysfunction
title_fullStr The Pull-Through Technique for Recanalization of Transjugular Intrahepatic Portosystemic Shunt Dysfunction
title_full_unstemmed The Pull-Through Technique for Recanalization of Transjugular Intrahepatic Portosystemic Shunt Dysfunction
title_short The Pull-Through Technique for Recanalization of Transjugular Intrahepatic Portosystemic Shunt Dysfunction
title_sort pull through technique for recanalization of transjugular intrahepatic portosystemic shunt dysfunction
url http://dx.doi.org/10.1155/2020/9150173
work_keys_str_mv AT siliangchen thepullthroughtechniqueforrecanalizationoftransjugularintrahepaticportosystemicshuntdysfunction
AT chengjiangxiao thepullthroughtechniqueforrecanalizationoftransjugularintrahepaticportosystemicshuntdysfunction
AT shuaiwang thepullthroughtechniqueforrecanalizationoftransjugularintrahepaticportosystemicshuntdysfunction
AT siyijin thepullthroughtechniqueforrecanalizationoftransjugularintrahepaticportosystemicshuntdysfunction
AT jianbozhao thepullthroughtechniqueforrecanalizationoftransjugularintrahepaticportosystemicshuntdysfunction
AT siliangchen pullthroughtechniqueforrecanalizationoftransjugularintrahepaticportosystemicshuntdysfunction
AT chengjiangxiao pullthroughtechniqueforrecanalizationoftransjugularintrahepaticportosystemicshuntdysfunction
AT shuaiwang pullthroughtechniqueforrecanalizationoftransjugularintrahepaticportosystemicshuntdysfunction
AT siyijin pullthroughtechniqueforrecanalizationoftransjugularintrahepaticportosystemicshuntdysfunction
AT jianbozhao pullthroughtechniqueforrecanalizationoftransjugularintrahepaticportosystemicshuntdysfunction