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    Parallel Shunt for the Treatment of Transjugular Intrahepatic Portosystemic Shunt Dysfunction

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    https://www.riss.kr/link?id=A104530296

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    다국어 초록 (Multilingual Abstract) kakao i 다국어 번역

    Objective: To investigate the safety, efficacy and long-term patency of parallel shunts (PS) in the management of the transjugular intrahepatic portosystemic shunt (TIPS) dysfunction.
    Materials and Methods: Between March 2007 and October 2010, 18 patients (13 men and 5 women) who underwent TIPS revision with the creation of PS were evaluated retrospectively. In the first 10 patients, a 10-mm-diameter Wallgraft endoprosthesis was deployed; in the latter 8 patients, an 8-mm-diameter Fluency endoprosthesis was deployed.
    Results: The creation of PS was technically successful in all patients. The mean ± standard deviation portosystemic pressure gradient before and after the procedure was 25.5 ± 7.3 mm Hg (range, 16-37 mm Hg) and 10.9 ± 2.3 mm Hg (range, 7-16 mm Hg), respectively. The duration of follow-up was 16.7 ± 10.8 months (range, 6-42 months). The primary shunt patency rates at 12 months after the creation of PS was 70% with Wallgraft endoprostheses and 87.5% with Fluency endoprostheses.
    Conclusion: TIPS revision with the creation of PS is a safe, effective and durable method for treating shunt dysfunction.
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    Objective: To investigate the safety, efficacy and long-term patency of parallel shunts (PS) in the management of the transjugular intrahepatic portosystemic shunt (TIPS) dysfunction. Materials and Methods: Between March 2007 and October 2010, 18 pat...

    Objective: To investigate the safety, efficacy and long-term patency of parallel shunts (PS) in the management of the transjugular intrahepatic portosystemic shunt (TIPS) dysfunction.
    Materials and Methods: Between March 2007 and October 2010, 18 patients (13 men and 5 women) who underwent TIPS revision with the creation of PS were evaluated retrospectively. In the first 10 patients, a 10-mm-diameter Wallgraft endoprosthesis was deployed; in the latter 8 patients, an 8-mm-diameter Fluency endoprosthesis was deployed.
    Results: The creation of PS was technically successful in all patients. The mean ± standard deviation portosystemic pressure gradient before and after the procedure was 25.5 ± 7.3 mm Hg (range, 16-37 mm Hg) and 10.9 ± 2.3 mm Hg (range, 7-16 mm Hg), respectively. The duration of follow-up was 16.7 ± 10.8 months (range, 6-42 months). The primary shunt patency rates at 12 months after the creation of PS was 70% with Wallgraft endoprostheses and 87.5% with Fluency endoprostheses.
    Conclusion: TIPS revision with the creation of PS is a safe, effective and durable method for treating shunt dysfunction.

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    참고문헌 (Reference)

    1 Cejna M, "ePTFE-covered stent-grafts for revision of obstructed transjugular intrahepatic portosystemic shunt" 25 : 365-372, 2002

    2 Haskal ZJ, "Transjugular intrahepatic transcaval portosystemic shunt: the gun-sight approach" 7 : 139-142, 1996

    3 Feldstein VA, "Transjugular intrahepatic portosystemic shunts: accuracy of Doppler US in determination of patency and detection of stenoses" 201 : 141-147, 1996

    4 Tanihata H, "Transjugular intrahepatic portosystemic shunt with silicone-covered Wallstents: results in a swine model" 205 : 181-184, 1997

    5 Haskal ZJ, "Transjugular intrahepatic portosystemic shunt stenosis and revision: early and midterm results" 163 : 439-444, 1994

    6 Saxon RS, "Transjugular intrahepatic portosystemic shunt patency and the importance of stenosis location in the development of recurrent symptoms" 207 : 683-693, 1998

    7 Richter GM, "The transjugular intrahepatic portosystemic stent-shunt. A new nonsurgical percutaneous method" 29 : 406-411, 1989

    8 Rössle M, "The transjugular intrahepatic portosystemic stent-shunt procedure for variceal bleeding" 330 : 165-171, 1994

    9 Ochs A, "The transjugular intrahepatic portosystemic stent-shunt procedure for refractory ascites" 332 : 1192-1197, 1995

    10 Helmy A, "The natural history of parallel transjugular intrahepatic portosystemic stent shunts using uncovered stent: the role of host-related factors" 26 : 572-578, 2006

    1 Cejna M, "ePTFE-covered stent-grafts for revision of obstructed transjugular intrahepatic portosystemic shunt" 25 : 365-372, 2002

    2 Haskal ZJ, "Transjugular intrahepatic transcaval portosystemic shunt: the gun-sight approach" 7 : 139-142, 1996

    3 Feldstein VA, "Transjugular intrahepatic portosystemic shunts: accuracy of Doppler US in determination of patency and detection of stenoses" 201 : 141-147, 1996

    4 Tanihata H, "Transjugular intrahepatic portosystemic shunt with silicone-covered Wallstents: results in a swine model" 205 : 181-184, 1997

    5 Haskal ZJ, "Transjugular intrahepatic portosystemic shunt stenosis and revision: early and midterm results" 163 : 439-444, 1994

    6 Saxon RS, "Transjugular intrahepatic portosystemic shunt patency and the importance of stenosis location in the development of recurrent symptoms" 207 : 683-693, 1998

    7 Richter GM, "The transjugular intrahepatic portosystemic stent-shunt. A new nonsurgical percutaneous method" 29 : 406-411, 1989

    8 Rössle M, "The transjugular intrahepatic portosystemic stent-shunt procedure for variceal bleeding" 330 : 165-171, 1994

    9 Ochs A, "The transjugular intrahepatic portosystemic stent-shunt procedure for refractory ascites" 332 : 1192-1197, 1995

    10 Helmy A, "The natural history of parallel transjugular intrahepatic portosystemic stent shunts using uncovered stent: the role of host-related factors" 26 : 572-578, 2006

    11 Clark TW, "The effect of initial shunt outflow position on patency of transjugular intrahepatic portosystemic shunts" 15 (15): 147-152, 2004

    12 Rössle M, "TIPS for the treatment of refractory ascites, hepatorenal syndrome and hepatic hydrothorax: a critical update" 59 : 988-1000, 2010

    13 Chih-Yang Chan, "Recanalization of an Occluded Intrahepatic Portosystemic Covered Stent via the Percutaneous Transhepatic Approach" 대한영상의학회 11 (11): 469-471, 2010

    14 Wen-Sheng Tzeng, "Prediction of Mortality after Emergent Transjugular Intrahepatic Portosystemic Shunt Placement: Use of APACHE II, Child-Pugh and MELD Scores in Asian Patients with Refractory Variceal Hemorrhage" 대한영상의학회 10 (10): 481-489, 2009

    15 Rossi P, "Polytetrafluoroethylene-covered nitinol stent-graft for transjugular intrahepatic portosystemic shunt creation: 3-year experience" 231 : 820-830, 2004

    16 Siegerstetter V, "Platelet aggregation and platelet-derived growth factor inhibition for prevention of insufficiency of the transjugular intrahepatic portosystemic shunt: a randomized study comparing trapidil plus ticlopidine with heparin treatment" 29 : 33-38, 1999

    17 Nishimine K, "Improved transjugular intrahepatic portosystemic shunt patency with PTFE-covered stent-grafts: experimental results in swine" 196 : 341-347, 1995

    18 Haskal ZJ, "Improved patency of transjugular intrahepatic portosystemic shunts in humans: creation and revision with PTFE stent-grafts" 213 : 759-766, 1999

    19 Bureau C, "Improved clinical outcome using polytetrafluoroethylene-coated stents for TIPS: results of a randomized study" 126 : 469-475, 2004

    20 Echenagusia M, "Expanded PTFE-covered stent-grafts in the treatment of transjugular intrahepatic portosystemic shunt (TIPS) stenoses and occlusions" 30 : 750-754, 2005

    21 Dabos KJ, "Efficacy of balloon angioplasty, restenting, and parallel shunt insertion for shunt insufficiency after transjugular intrahepatic portosystemic stent-shunt (TIPSS)" 7 : 287-293, 1998

    22 Ji Seon Park, "Effects of Intraluminal Irradiation with Holmium-166 for TIPS Stenosis: Experimental Study in a Swine Model" 대한영상의학회 8 (8): 127-135, 2007

    23 García-Pagán JC, "Early use of TIPS in patients with cirrhosis and variceal bleeding" 362 : 2370-2379, 2010

    24 Cejna M, "Creation of transjugular intrahepatic portosystemic shunts with stent-grafts: initial experiences with a polytetrafluoroethylene-covered nitinol endoprosthesis" 221 : 437-446, 2001

    25 Cura M, "Causes of TIPS dysfunction" 191 : 1751-1757, 2008

    26 Boyer TD, "American Association for the Study of Liver Diseases. The Role of Transjugular Intrahepatic Portosystemic Shunt (TIPS) in the Management of Portal Hypertension: update 2009" 51 : 306-, 2010

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