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Transjugular intrahepatic portosystemic stent shunts. Preliminary results in 18 patients.
Chin Med J (Engl). 1994 Aug; 107(8):604-9.CM

Abstract

In 18 consecutive patients receiving the transjugular intrahepatic portosystemic stent shunts (TIPSS), 15 were male and 3 female. The patients aged from 34 to 66 years had liver cirrhosis with portal hypertension and esophageal varices. Twelve had recurrent bleedings from raptured gastroesophageal varices. Shunts were established in 16 of the 18 patients and no operative death was noted. Portal vein pressure was reduced from 3.98 +/- 0.24 kPa before shunting to 2.40 +/- 0.16 kPa after shunting. Doppler ultrasound examination revealed that the maximum blood flow velocity in the main portal vein increased from 14.0 +/- 4.5 cm/sec to 48.0 +/- 16.5 cm/sec. The mean follow-up time in the successful cases was 4.5 months (range 2-8 months). The shunt patency was determined with color Doppler ultrasound in 15 patients: occlusion in one and no accites in 4. Varices disappeared in 8 patients and became less evident in 7. No patients had recurrence of varices bleeding or encephalopathy during follow-up. The results suggest that TIPSS is a safe and effective method for portal decompression in the treatment of variceal hemorrhage, and that portal vein puncture is largely dependent on understanding the three-dimensional relationships between hepatic and portal veins. To achieve an adequate portal decompression, we recommend that a stent of 12 mm in diameter be used in severe cases.

Authors+Show Affiliations

Zhang JS
Department of Radiology, PLA General Hospital, Beijing.
Wang MQ
No affiliation info available
Yang L
No affiliation info available
Cui ZP
No affiliation info available
Xing CC
No affiliation info available
Yu M
No affiliation info available

MeSH

AdultAgedEsophageal and Gastric VaricesFemaleFollow-Up StudiesGastrointestinal HemorrhageHumansHypertension, PortalLiver CirrhosisMaleMiddle AgedPortasystemic Shunt, SurgicalRadiography, InterventionalStents

Pub Type(s)

Journal Article

Language

eng

PubMed ID

7805446

Citation

Zhang, J S., et al. "Transjugular Intrahepatic Portosystemic Stent Shunts. Preliminary Results in 18 Patients." Chinese Medical Journal, vol. 107, no. 8, 1994, pp. 604-9.
Zhang JS, Wang MQ, Yang L, et al. Transjugular intrahepatic portosystemic stent shunts. Preliminary results in 18 patients. Chin Med J (Engl). 1994;107(8):604-9.
Zhang, J. S., Wang, M. Q., Yang, L., Cui, Z. P., Xing, C. C., & Yu, M. (1994). Transjugular intrahepatic portosystemic stent shunts. Preliminary results in 18 patients. Chinese Medical Journal, 107(8), 604-9.
Zhang JS, et al. Transjugular Intrahepatic Portosystemic Stent Shunts. Preliminary Results in 18 Patients. Chin Med J (Engl). 1994;107(8):604-9. PubMed PMID: 7805446.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transjugular intrahepatic portosystemic stent shunts. Preliminary results in 18 patients. AU - Zhang,J S, AU - Wang,M Q, AU - Yang,L, AU - Cui,Z P, AU - Xing,C C, AU - Yu,M, PY - 1994/8/1/pubmed PY - 1994/8/1/medline PY - 1994/8/1/entrez SP - 604 EP - 9 JF - Chinese medical journal JO - Chin Med J (Engl) VL - 107 IS - 8 N2 - In 18 consecutive patients receiving the transjugular intrahepatic portosystemic stent shunts (TIPSS), 15 were male and 3 female. The patients aged from 34 to 66 years had liver cirrhosis with portal hypertension and esophageal varices. Twelve had recurrent bleedings from raptured gastroesophageal varices. Shunts were established in 16 of the 18 patients and no operative death was noted. Portal vein pressure was reduced from 3.98 +/- 0.24 kPa before shunting to 2.40 +/- 0.16 kPa after shunting. Doppler ultrasound examination revealed that the maximum blood flow velocity in the main portal vein increased from 14.0 +/- 4.5 cm/sec to 48.0 +/- 16.5 cm/sec. The mean follow-up time in the successful cases was 4.5 months (range 2-8 months). The shunt patency was determined with color Doppler ultrasound in 15 patients: occlusion in one and no accites in 4. Varices disappeared in 8 patients and became less evident in 7. No patients had recurrence of varices bleeding or encephalopathy during follow-up. The results suggest that TIPSS is a safe and effective method for portal decompression in the treatment of variceal hemorrhage, and that portal vein puncture is largely dependent on understanding the three-dimensional relationships between hepatic and portal veins. To achieve an adequate portal decompression, we recommend that a stent of 12 mm in diameter be used in severe cases. SN - 0366-6999 UR - https://www.unboundmedicine.com/medline/citation/7805446/Transjugular_intrahepatic_portosystemic_stent_shunts__Preliminary_results_in_18_patients_ L2 - https://medlineplus.gov/cirrhosis.html DB - PRIME DP - Unbound Medicine ER -