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[Hemodynamics, liver function and clinical follow-up after TIPS].
Radiologe. 1994 Apr; 34(4):183-6.R

Abstract

In 126 patients with liver cirrhosis treated electively with transjugular intrahepatic portosystemic stent shunt (TIPS) to prevent variceal rebleeding, the portosystemic pressure gradient decreased by 60%. In spite of this incomplete effect the risk for variceal rebleeding was still under 20% after 2 years. Only 1 patient died of variceal rebleeding. Shunt insufficiency occurred in 50%, mainly during the first year, but shunt function was restored in nearly all cases by radiologic intervention, i.e., redilatation or implantation of an additional stent. During the follow-up of 16 +/- 9 months, 21 patients (17%) died, one-third of them from progressive liver failure aggravated in 4 cases by severe drinking. De novo hepatic encephalopathy was observed in 10%, especially in older patients and patients with impaired liver function before TIPS. In such patients it is recommended that the shunt be dilated to 0.8 cm at most, and the TIPS procedure can be combined with transjugular embolization of the varices. The advantages of TIPS over both endoscopic sclerotherapy and drug treatment must be clarified in randomized studies, which have already been initiated in several centers.

Authors+Show Affiliations

Radiologische Universitätsklinik, Freiburg.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

ger

PubMed ID

8052710

Citation

Haag, K, et al. "[Hemodynamics, Liver Function and Clinical Follow-up After TIPS]." Der Radiologe, vol. 34, no. 4, 1994, pp. 183-6.
Haag K, Ochs A, Deibert P, et al. [Hemodynamics, liver function and clinical follow-up after TIPS]. Radiologe. 1994;34(4):183-6.
Haag, K., Ochs, A., Deibert, P., Siegerstetter, V., Hauenstein, K. H., Berger, E., Gerok, W., Langer, M., & Rössle, M. (1994). [Hemodynamics, liver function and clinical follow-up after TIPS]. Der Radiologe, 34(4), 183-6.
Haag K, et al. [Hemodynamics, Liver Function and Clinical Follow-up After TIPS]. Radiologe. 1994;34(4):183-6. PubMed PMID: 8052710.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Hemodynamics, liver function and clinical follow-up after TIPS]. AU - Haag,K, AU - Ochs,A, AU - Deibert,P, AU - Siegerstetter,V, AU - Hauenstein,K H, AU - Berger,E, AU - Gerok,W, AU - Langer,M, AU - Rössle,M, PY - 1994/4/1/pubmed PY - 1994/4/1/medline PY - 1994/4/1/entrez SP - 183 EP - 6 JF - Der Radiologe JO - Radiologe VL - 34 IS - 4 N2 - In 126 patients with liver cirrhosis treated electively with transjugular intrahepatic portosystemic stent shunt (TIPS) to prevent variceal rebleeding, the portosystemic pressure gradient decreased by 60%. In spite of this incomplete effect the risk for variceal rebleeding was still under 20% after 2 years. Only 1 patient died of variceal rebleeding. Shunt insufficiency occurred in 50%, mainly during the first year, but shunt function was restored in nearly all cases by radiologic intervention, i.e., redilatation or implantation of an additional stent. During the follow-up of 16 +/- 9 months, 21 patients (17%) died, one-third of them from progressive liver failure aggravated in 4 cases by severe drinking. De novo hepatic encephalopathy was observed in 10%, especially in older patients and patients with impaired liver function before TIPS. In such patients it is recommended that the shunt be dilated to 0.8 cm at most, and the TIPS procedure can be combined with transjugular embolization of the varices. The advantages of TIPS over both endoscopic sclerotherapy and drug treatment must be clarified in randomized studies, which have already been initiated in several centers. SN - 0033-832X UR - https://www.unboundmedicine.com/medline/citation/8052710/[Hemodynamics_liver_function_and_clinical_follow_up_after_TIPS]_ L2 - https://medlineplus.gov/gastrointestinalbleeding.html DB - PRIME DP - Unbound Medicine ER -