Are TIPS Tops in the Treatment of Portal Hypertension? A Review on the Use and Misuse of Transjugular Intrahepatic Portosystemic Shunts
Complications of portal hypertension are the Achilles heel of end-stage liver disease. Although initially developed in the 1960s, transjugular intrahepatic portosystemic shunts (TIPS) have recently gained popularity for decompressing the portal vein in patients with portal hypertension. The main ind...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2000-01-01
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| Series: | Canadian Journal of Gastroenterology |
| Online Access: | http://dx.doi.org/10.1155/2000/309539 |
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| Summary: | Complications of portal hypertension
are the Achilles heel of end-stage liver disease. Although
initially developed in the 1960s, transjugular intrahepatic portosystemic
shunts (TIPS) have recently gained popularity for decompressing
the portal vein in patients with portal hypertension.
The main indications for TIPS are the treatment of variceal hemorrhage
unresponsive to endoscopic treatment and refractory ascites.
Although several other applications for TIPS have been
reported, they have not been tested in controlled trials. TIPS are
not appropriate as initial therapy for variceal hemorrhage and ascites.
Due to the virtually universal development of TIPS stenosis
in the majority of patients, careful monitoring of stent patency is
required. Several complications of TIPS are recognized, some of
which are potentially fatal. Consequently, careful patient selection
for TIPS is of paramount importance. Until further clinical
trials become available, TIPS should be considered as a therapeutic
option for the treatment of refractory variceal hemorrhage and
refractory ascites in selected patients. |
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| ISSN: | 0835-7900 |