logo
搜索
我的图书馆

发文章

发文工具

其他工具

留言交流
搜索
分享

2021北美经颈静脉肝内门体分流术治疗门静脉高压症的专家共识

 jiianwhy 2022-06-19 发布于山东

2021北美经颈静脉肝内门体分流术治疗门静脉高压症的专家共识.pdf



门静脉高压的并发症，包括腹水、胃肠道出血、肝性胸水和肝性脑病，与显著的发病率和死亡率相关。尽管很少有高质量的随机对照试验来指导治疗决策，但是建立经颈静脉肝内门体静脉分流术(TIPS)已成为治疗门静脉高压并发症的重要治疗选择。在北美，进行TIPS的决策涉及胃肠病学家、肝病学家和介入放射科医生，但TIPS的创建由介入放射科医生进行。这与世界其他地区主要由肝病专家创建TIPS相反。因此，在北美成功使用TIPS取决于多学科诊疗和技术专长，从而优化结果。最近，出现了新的操作技术、TIPS支架技术和TIPS的适应症。因此，不同机构的实践和结果差异很大，存在显著的技术差距。在这份共识声明中，先进肝脏治疗方法小组严格审查了TIPS在门静脉高压症管理中的应用。先进的肝脏治疗方法召集了一个北美肝病、介入放射学、移植学、肾脏病学、心脏病学、肺病学的多学科专家小组，和血液学专业审查现有文献，并针对TIPS治疗任何原因引起的门静脉高压症患者，在候选者、最佳操作规范和TIPS术后管理方面提出基于实践的建议；并制定TIPS适应症和并发症预防的共识。

——摘要



【DOIhttps:///10.1016/j.cgh.2021.07.018



TIPS术前注意事项


问题1

谁应该参与TIPS的决策，建议进行那些术前咨询？

在创建TIPS之前，我们建议胃肠病学家或肝病学家应参与创建紧急或择期TIPS治疗的初始决策，随后由介入放射科医生或其他具有TIPS能力的手术医生进行会诊。如果该中心不能提供tips治疗，我们建议转诊至具备tips治疗能力的中心。其他专科咨询（如移植手术、心脏病学、重症监护、血液学、肾脏病学）可根据具体情况考虑。证据级别5


问题2

实施TIPS的中心应提供哪些服务，应建立哪些转诊途径以获得更高水平的治疗？

对于所有接受TIPS治疗的患者，我们建议TIPS应在具有介入放射学，胃肠病学/肝病学，心脏病学，肺外科，血液学，肾脏病学和重症监护服务的中心进行，以便为TIPS前后的患者管理提供足够的医疗支持。对于需要更高级别治疗的患者，例如可能的肝移植候选者，或者需要进一步介入治疗的患者（例如，广泛的门静脉血栓形成），我们建议转诊至在这些领域具有足够经验的中心。证据级别5


问题3

是否存在MELD阈值，不应考虑高于该阈值的选择性TIPS？

对于接受 TIPS 治疗的肝硬化患者，建议采用多学科诊疗（而不是绝对的 MELD 临界值）来评估 TIPS 候选资格。证据级别2a


问题4

TIPS创建前需要进行哪些影像学或术前评估？

a。对于接受选择性 TIPS 的患者，我们建议：· 对比增强多相横断面成像 (CT/MRI) 以帮助制定 TIPS 计划。· 综合超声心动图来评估心脏结构、功能和右心室收缩压的异常。证据级别2a

b。对于接受紧急 TIPS 的肝硬化患者，应进行最佳临床判断。我们建议至少使用多普勒进行肝脏超声来评估门静脉系统的通畅性，并考虑使用（床边）超声心动图，评估左心室射血分数和右心室收缩压。证据级别3


问题5

选择性经TIPS的绝对禁忌症是什么？

选择性 TIPS 的绝对禁忌症包括：· 重度充血性心力衰竭（ACC/AHA C 或 D HF 期）
· 严重未经治疗的瓣膜性心脏病（AHA/ACC C 或 D VHD）· 经过治疗，仍中重度肺动脉高压（基于侵入性测量）· 不受控制的全身感染· 难治性HE· 胆道梗阻未缓解· 肝实质中妨碍 TIPS 建立的病变（例如，囊肿）或肿瘤.证据级别2a


问题6

所有患者在TIPS创建前都应接受肝移植评估吗？

在接受择期或紧急 TIPS 的肝硬化患者中，没有足够的证据推荐普遍的术前肝移植评估。证据级别5



TIPS手术的注意事项



问题7

谁来执行TIPS手术？

我们建议TIPS的创建应由有资质的、委员会认证的介入放射科医生或经过培训并通过认证的医生进行.证据级别5


问题8

推荐哪种类型的支架用于TIPS？

对于接受 TIPS 治疗的患者，我们建议使用具有可控扩张的 ePTFE 覆膜支架 (1b)，这可以使介入医生根据适应症、目标梯度和患者合并症来调整门体分流的血流量 (2b)。证据级别1b和2b


问题9

在TIPS创建之前是否应该纠正凝血障碍？

由于证据不足，我们不建议在肝硬化患者中进行 TIPS 时使用特定的目标 INR 或血小板阈值。证据级别2b


问题10

围手术期抗生素是否应常规用于TIPS？

没有研究表明在 TIPS 创建期间常规使用抗生素可减少感染并发症，其使用应取决于患者和危险因素。证据级别5


问题11

是否应使用全身麻醉、深度或清醒镇静进行TIPS？

全身麻醉、深度镇静或清醒镇静的使用都可能适合 TIPS 创建，它们的使用将根据患者的风险因素和当地医院可用的医疗资源。证据级别5


问题12

是否推荐使用血管内超声辅助门静脉穿刺？

对于接受 TIPS 创建的患者，虽然没有足够的证据推荐使用血管内超声引导，但在某些情况下它可能有助于通路的建立。它的使用将取决于设备的可用性和医生的偏好。证据级别3b


问题13

在TIPS创建时，测量全身静脉压的最佳位置是什么（肝静脉、IVC、右心房）？

在 TIPS 创建前后测量门体梯度时，我们建议使用游离肝静脉或 IVC 压力作为全身压力。证据级别2a


问题14

是否应考虑特定的技术因素以确保TIPS不会对肝移植候选患者产生不利影响？

a。对于可能适合肝移植的 TIPS 患者，我们建议将支架放置在不干扰门静脉和肝静脉吻合的位置，假设这不会对 TIPS 功能或通畅性产生不利影响。这种定位包括留下一段未支架的主要门静脉，并且不将 TIPS 支架延伸到右心房。证据级别5

b。肝移植候选患者不应受到 TIPS 位置的影响。证据级别2a



 TIPS术后患者的护理


问题15

术后加强监测的建议持续时间是多少？

创建 TIPS 后，我们建议所有患者至少接受住院过夜观察。TIPS 后观察期间的护理水平应取决于患者的状况、TIPS 适应症和术中技术复杂性。证据级别5


问题16

TIPS创建后建议进行哪些早期检测（实验室和影像学检查）？间隔多长时间？

a。在所有接受 TIPS 创建的患者中，应在 TIPS 创建后的第二天进行常规实验室检查（全血细胞计数、综合代谢面板和 PT/INR）。血红蛋白/血细胞比容实验室测试可在 TIPS 创建的同一天进行，具体取决于医院或医生的判断。证据级别5

b。大多数接受 TIPS 治疗的患者并不需要出院前影像学检查.证据级别5


问题17

TIPS静脉造影和介入治疗应基于超声、临床结果还是两者兼而有之？

a。在接受TIPS治疗静脉曲张的患者中，多普勒超声检查结果提示TIPS功能障碍或门静脉高压并发症持续或复发时，应立即进行TIPS静脉造影术和测压±介入治疗。提示TIPS功能障碍的超声结果包括肝内门静脉血流方向的改变、TIPS内血流速度异常以及持续性（例如，TIPS后> 6周）或复发性腹水。证据级别2b

b。在为治疗腹水或肝性胸水而接受TIPS建立的患者中，门静脉高压并发症的持续或复发应及时进行TIPS静脉造影术和测压±介入治疗。对于控制良好的腹水或肝性胸水且超声结果提示TIPS功能障碍的患者，医学决策应个体化。证据级别2b

c。在选择的患者中，建议在TIPS术后早期（1-2个月）进行计划的TIPS静脉造影和介入治疗。这种情况的一个示例是在门静脉血栓形成患者中创建TIPS。证据级别5


问题18

在需要干预时,增加或减少 TIPS 流量的最佳技术是什么？

a。对于需要进一步降低门静脉压力的患者，我们建议将 TIPS 逐步扩张至其最大直径。如果它已经达到最大直径，则应评估降低门静脉压力的其他干预措施（例如，非选择性 β 受体阻滞剂、平行 TIPS 的建立）。b。对于需要增加门静脉压力的患者，没有足够的证据推荐通过 TIPS 减少门体分流的特定技术。证据级别5


问题19

谁应该对TIPS患者进行随访评估

对于接受了 TIPS 治疗的患者，我们建议胃肠病学家或肝病学家和有能力的手术医师（例如介入放射科医生）对患者进行随访，以确保对慢性肝病、手术后并发症的持续管理，并确定是否需要对tips修复。证据级别5

提示：根据放射学专业协会指南，TIPS置入必须由具有委员会认证或认证培训以及足够的TIPS操作经验的医生进行。在没有认证或认证培训的情况下，除其他血管内技术（即，至少100次血管造影、50次血管成形术、10次支架置入、和5次栓塞），已经达到了预期的手术完成阈值，并且已经获得了他们所在中心的适当授权。



 腹水或肝性胸水的TIPS

 

问题1

在肝硬化和顽固性腹水患者中建立TIPS的最佳技术方法是什么？

a。对于接受择期 TIPS 的肝硬化和利尿剂难治性或难治性腹水的患者，我们建议使用 ePTFE 可控扩张覆膜支架。证据级别2b

b。对于接受择期 TIPS 的肝硬化和利尿剂难治性或难治性腹水的患者，我们建议采用分阶段的方法来创建 TIPS，首先将支架扩张至 8 mm，然后进行临床评估，然后进行性支架扩张至 9 mm，如果需要优化临床反应，应间隔 6 周进行。证据级别2b

 

问题2

 与连续 LVP 治疗顽固性腹水相比，TIPS 与更好的结果（死亡率、腹水控制）相关吗？

a。对于经过精心挑选的肝硬化和顽固性腹水患者，建议使用 TIPS 而非 LVP 来预防复发性腹水。证据级别1a

b。对于经过精心挑选的肝硬化和顽固性腹水患者，建议 TIPS 优于 LVP，以提高无移植生存率。证据级别1a


问题3

是否存在肝功能障碍阈值，超过该阈值时应禁用TIPS治疗难治性腹水，应如何定义？

在肝硬化和难治性腹水患者中，胆红素升高、MELD评分升高和CTP C级肝硬化与TIPS术后并发症增加相关，包括死亡率。没有足够的证据推荐一个临界值，或超过该临界值的任何测量均应视为TIPS的禁忌症。证据级别1a


问题4

 年龄对难治性腹水TIPS的候选资格有何影响？

在伴有肝硬化和难治性腹水的患者中，高龄与TIPS术后并发症（包括重度肝性脑病和死亡）显著相关。没有足够的证据推荐临界年龄应视为TIPS的禁忌症。证据级别1a

 

问题5

 TIPS术对非难治性腹水患者的作用是什么？

对于不满足难治性腹水的严格定义，但尽管接受了最佳药物治疗，仍在一年内需要至少3次LVP治疗张力性腹水的患者，我们建议应考虑创建TIPS。证据级别1a


问题6

TIPS 在 HHT 中的作用是什么？腹水患者与 HHT 患者的选择是否相似？

对于需要反复胸腔穿刺术的 HHT 患者，我们建议应考虑 TIPS。证据级别2b


问题7

 既往肝移植是 TIPS 治疗顽固性腹水的禁忌症吗？对于难治性腹水的肝移植患者，TIPS 是否比手术分流术、连续 LVP 或脾动脉栓塞术更好？

与针对肝硬化腹水和 HHT 的 TIPS 不同，没有足够的证据支持对难治性腹水的肝移植患者进行治疗（TIPS 和其他方式）的任何建议。证据级别2b


问题8

TIPS有效减少腹水/肝性胸水的预期时限是多少？

在为腹水或肝性胸水创建 TIPS 的情况下，我们建议使用分阶段的方法，从最小直径的 TIPS 支架开始，并在耐受的情况下同时使用利尿剂。应每 6 周重新评估是否需要进一步扩张 TIPS 支架。证据级别2b



TIPS治疗静脉曲张出血 

 

问题1

 急性静脉曲张出血何时需要TIPS？

对于急性静脉曲张出血，我们建议在以下情况下创建 TIPS：

· 对成功套扎但符合再出血高风险标准的患者进行挽救 TIPS。高风险标准是 CTP C 级（10-13 分）或 CTP B 级 >7 分且内镜检查时有活动性出血。对于没有 TIPS 禁忌症的患者，应在入院 72 小时内进行 TIPS。证据级别1c

· 对成功套扎但入院期间（内窥镜检查后）随时再次出血的患者进行 TIPS 挽救治疗。证据级别2a

· 对于因大量出血而无法进行内窥镜套扎术的患者，或者尽管进行了内窥镜套扎术，但在内窥镜下仍有出血时，应紧急进行挽救性 TIPS。证据级别2b

 

问题2

何时应使用TIPS治疗胃底静脉曲张出血？

a。我们建议胃底静脉曲张出血的初始处理应基于各中心可用的医疗资源。如果胃底静脉曲张出血不能通过内镜进行处理，应考虑静脉曲张栓塞/加或不加 TIPS。证据级别5

b。对于内窥镜治疗后胃底静脉曲张再出血，我们建议对静脉曲张闭塞/使用或不使用 TIPS 创建。证据级别2b

 

问题3

TIPS治疗静脉曲张出血的程序注意事项是什么？

a。当建立TIPS治疗静脉曲张出血时，我们建议目标 PSG <12 mm Hg 或从初始值降低 50%–60%。我们不建议使用分流直径作为手术终点。证据级别2b

b。在为静脉曲张出血创建 TIPS 的情况下，我们建议同时闭塞静脉曲张。证据级别1b

 

问题4

 TIPS治疗静脉曲张出血后应如何监测患者？

a。在为静脉曲张出血创建 TIPS 的情况下，我们建议在创建 TIPS 后 3 个月和之后每 6 个月使用多普勒超声检查监测 TIPS 后的狭窄或闭塞。证据级别5

b。如果怀疑 TIPS 狭窄/闭塞，或者如果患者在创建 TIPS 后再次出血，则在考虑 TIPS 修复时，进行TIPS 静脉造影压力测量。证据级别2b



经颈静脉肝内门体分流术的新适应症


问题1

在门静脉高压症患者中，术前创建TIPS是否可减少非移植性腹部手术后的手术并发症和/或改善围手术期结局？

a。在需要接受非移植手术的门静脉高压症患者中，没有足够的证据来建议在侵入性非移植手术期间或之后，术前TIPS可预防出血并发症或需要输血。证据级别1b

b。在无临床显著腹水的肝硬化患者中，没有足够的证据推荐在腹部手术中进行术前TIPS，以预防腹水的并发症。在伴有需要腹部手术的临床显著性腹水的肝硬化患者中，建议采用多学科团队方法（肝脏病学和肝胆外科）进行个体化外科/内科治疗。证据级别3b

c。没有证据表明术前 TIPS 对侵入性非移植手术后的术后死亡率有影响。证据级别3b

 

问题2

 肝硬化和门静脉阻塞患者的经颈静脉肝内门体分流术是否有助于肝移植或改善肝移植后的结果？

a。在肝硬化和慢性门静脉完全血栓形成、门静脉血管再通和TIPS建立的患者中，可考虑促进移植资格。证据级别3b

b。对于其他原因被考虑进行肝移植或由于与完全性门静脉阻塞相关的技术挑战而被拒绝列入肝移植的肝硬化和完全性门静脉血栓形成患者，应考虑进行门静脉重建和TIPS。可能需要转诊至具有专业经验的中心。证据级别5

 

问题3

TIPS的建立是否可预防或减少因肝外门静脉阻塞引起的非肝硬化门静脉高压症患者的门静脉高压并发症？

a。对于非肝硬化门静脉高压症和急性门静脉血栓形成的患者，我们建议立即抗凝。对于抗凝治疗失败或反应不佳的患者，我们建议应考虑使用经颈静脉途径进行门静脉血栓切除术/溶栓术，无论是否创建小口径 TIPS。证据级别4

b。在非危重的急性非肝硬化门静脉血栓形成患者中，证据不足以推荐 TIPS 与单独抗凝。鉴于报告的静脉再通率，我们建议首先考虑抗凝试验。证据级别2b

c。对于继发于抗凝治疗无反应的非肝硬化肝外门静脉阻塞的慢性门静脉高压症患者，TIPS 可考虑用于与肝硬化门静脉高压症相同的适应症。证据级别5


问题4

 特发性非肝硬化门静脉高压症患者无肝外门静脉阻塞的经颈静脉肝内门体分流术能否预防或减少门静脉高压症并发症？

在患有慢性特发性门静脉高压症/门静脉窦血管疾病的患者中，TIPS 可考虑用于与肝硬化门静脉高压症相同的适应症。证据级别2b


问题5

TIPS能否改善 Budd-Chiari 综合征患者的预后？

a。Budd–Chiari综合征患者应该在具有血液学评估、临床管理和经皮介入经验和专业知识的中心进行评估和治疗。理想情况下，如果在初始评价或后续随访评价时有必要，该中心还将具备肝移植的资质。如果治疗机构没有这些资源，则在启动医疗管理的同时，应充分考虑将患者转移到有资质的机构。证据级别5

b。Budd–Chiari综合征患者在开始适当的药物治疗后仍有症状或肝功能未改善，以及不适合经皮肝静脉流出道血运重建（短段梗阻）、建立经皮门体静脉分流术的患者，应重点考虑TIPS或直接肝内门体分流术。证据级别2b

c。对于接受 TIPS 的 Budd-Chiari 综合征患者，我们建议密切临床监测和影像学随访评估。证据级别4



 经颈静脉肝内门体分流术的心肺考虑因素


问题1

择期经颈静脉肝内门体分流术前需要进行哪些心肺检查？

a。在接受择期TIPS建立的患者中，我们建议在可行的情况下，除了评估LVEF外，还纳入全面的超声心动图评价，测量左心室整体纵向应变，以及左室舒张功能的现代替代指标。证据级别2b

b。对于接受选择性 TIPS 创建的患者，我们建议使用 TAPSE 和 RVSP 评估右心室功能。右心室劳损尚未成为大多数中心的标准治疗，但应在条件允许时进行测量。证据级别5

c。对于 RVSP 超过 45 mm Hg 或 TAPSE 小于 1.6 cm 的 TIPS 患者，我们建议转诊至心脏病科考虑右心导管术，以在 TIPS 创建前评估右心室功能障碍和肺动脉高压。证据级别5


问题2

 肝硬化性心肌病或舒张功能障碍是否会增加经颈静脉肝内门体分流术后心力衰竭的风险？

a。对于接受选择性 TIPS 创建的患者，我们建议考虑存在收缩或舒张功能障碍，这可能表明在没有其他心脏病史的情况下存在肝硬化心肌病，这是 TIPS 后心力衰竭的重要危险因素。证据级别2b

b。在接受选择性 TIPS 评估的患者中，如果 LVEF <50% 或存在 III 级舒张功能障碍，考虑到 TIPS 后心脏失代偿的风险，我们建议避免 TIPS。证据级别5

 

问题3

 TIPS能否安全用于中度或重度门脉性肺动脉高压患者？

a。对于正在接受治疗的中度或重度 POPH 患者（即平均肺动脉压 >35 mm Hg，肺血管阻力 >3 个wood单位），我们建议在考虑置入 TIPS 时要格外小心，因为它可能会导致右侧心力衰竭。证据级别5

b。对于接受选择性 TIPS 且筛查时没有 POPH 证据的患者，我们建议在计划 TIPS 时测量右心房压力，如果 >14 mm Hg，我们建议在创建 TIPS 前考虑右心导管检查以排除 POPH临床情况。证据级别5

 

问题4

 严重的三尖瓣反流是否会妨碍TIPS的创建？

对于尽管容量超负荷已得到优化但仍存在中度或重度三尖瓣反流的患者，我们建议对其进行潜在心肺病因的评价，这可能禁止进行TIPS。证据级别5


问题5

TIPS可以治疗肝肺综合征吗？

我们不推荐将 TIPS 作为 HPS 的治疗方法，但可以考虑将其用于已确定 TIPS 适应症的 HPS 患者。证据级别4


问题6

支架尺寸是否会影响高心脏风险患者的TIPS术后心力衰竭的风险？

对于正在接受 TIPS 的有收缩或舒张功能障碍或轻度 POPH 的患者，我们建议通过最初将支架扩张到 8 mm 直径来平衡所需的门体梯度与可能恶化的心脏功能。如果达到所需的梯度，则不应再对支架进行额外的扩张。证据级别5


问题7

 是否需要经颈静脉肝内门体分流后超声心动图监测？

对于有收缩或舒张功能障碍、肺动脉高压或中度至重度瓣膜疾病的患者，如果有指征，我们建议在 TIPS 后 3 个月或更早时进行超声心动图监测。如果 3 个月时超声心动图恶化（与基线相比）或有临床指征，则可以考虑进行 3 个月以上的监测。证据级别5



经颈静脉肝内门体分流术的肾脏考虑因素

 

问题1

 在经颈静脉肝内门体分流术之前或之后评估肾功能的最佳标志物是什么？

a。在接受 TIPS 的肝硬化患者中，应在手术前通过测量血清肌酐或 GFR（估计或测量）来评估肾功能。GFR 的变化可能更好地反映肾功能的变化，尽管没有足够的证据来推荐。证据级别5

b。评估患有肌肉减少症或慢性肾病的肝硬化患者肾功能的最佳方法尚不清楚。证据级别5

 

问题2

是否存在禁忌经颈静脉肝内门体分流术的肾功能绝对临界值？

没有足够的证据推荐绝对血清肌酐、CKD 分期或存在/不存在 TIPS 禁忌的肾脏替代治疗。证据级别5


问题3

 经颈静脉肝内门体分流术后如何预防肾脏并发症？

a。在行TIPS治疗腹水的患者中，应考虑对所有同时行腹腔穿刺的患者输注白蛋白，尤其是清除 > 5 L的患者，以预防腹腔穿刺诱发的循环功能障碍和AKI。证据级别1a

b。LVP 与白蛋白输注可在 TIPS 创建前 24 小时内或同时进行。证据级别5

c。充分补水和明智地使用含碘造影剂是有助于降低造影剂相关损伤风险的合理策略.证据级别2b。

d。在 TIPS 前发生 AKI/CKD 或在 TIPS 创建后发生 AKI 的患者中，应在 TIPS 创建后 1 周内密切随访肾功能。证据级别5


问题4

经颈静脉肝内门体分流术对肝肾综合征有何作用？

a。没有足够的证据推荐或反对使用 TIPS 治疗 HRS；然而，在存在其他适应症（如顽固性腹水、静脉曲张出血）的情况下，存在 HRS 并不是创建 TIPS 的绝对禁忌症。证据级别2a

b。接受 TIPS 的 HRS 患者的死亡率似乎是由肝功能（即血清胆红素，INR）驱动的，因此，建议仔细选择患者。证据级别4



肝性脑病和经颈静脉肝内门体分流术


问题1

 经颈静脉肝内门体分流术后发生明显肝性脑病的风险是什么？哪些患者特异性因素促成了HE的发生？

我们建议告知患者 TIPS 与大约 25%–50% 的明显 HE 风险相关 (1b)。TIPS术后发生显性HE的患者特异性风险因素包括既往显性HE病史、高龄、晚期肝功能障碍（CTP C级）、低钠血症、肾功能障碍和肌肉减少。证据级别1b.2a


问题2

 由于选择性TIPS与显性HE相关，应将哪些社会因素视为禁忌症？

我们建议在认知障碍和家庭或社会支持有限的患者中避免选择性 TIPS。证据级别3

 

问题3

 在择期TIPS之前，对隐匿性或轻微肝性脑病进行正式评估的作用是什么？

在考虑进行选择性TIPS的患者中，可考虑进行隐匿性或轻微HE检测，以进行预后判断并与患者进行讨论。证据级别2

 

问题4

 为了限制TIPS术后肝性脑病，应考虑多大的TIPS支架直径？

对于因腹水而接受选择性 TIPS 的患者，我们建议从较小直径的可控扩张支架开始，以潜在地降低 HE 的发生率。证据级别4


问题5

5a。TIPS时侧支栓塞对预防肝性脑病有作用吗？

对于因腹水或肝性胸水而接受选择性 TIPS 的患者，可考虑栓塞 SPSS > 6 mm 以降低 TIPS 后肝性脑病的风险。证据级别4

 5b。TIPS联合分流栓塞在治疗与假定的门体分流术相关的难治性肝性脑病中是否有作用？

对于大 (>6 mm) SPSS 和难治性 HE 的特定患者，我们建议考虑分流栓塞。对于在分流栓塞后出现门静脉高压相关并发症（腹水、静脉曲张）的特定患者，我们建议可以考虑创建小口径 TIPS。证据级别4

 

问题6

a。TIPS后，药物预防对预防肝性脑病有何作用？

对于没有接受 TIPS 的明显 HE 病史的患者，我们不建议在 TIPS 后采取药物预防措施来预防 HE。证据级别3

b。TIPS后明显肝性脑病的推荐药物治疗是什么？

我们建议根据当前指南使用乳果糖和利福昔明对 TIPS 后明显 HE 进行医疗管理。证据级别1

 6c。TIPS支架复位/封堵治疗持续性或难治性肝性脑病的作用是什么？

对于 TIPS 后持续性或难治性 HE 患者，我们建议考虑减小 TIPS 支架直径。证据级别2b

【参考文献】

  • Introduction to the revised American Association for the Study of Liver Diseases Practice Guideline management of adult patients with ascites due to cirrhosis 2012.

    Hepatology. 2013; 57: 1651-1653

    View in Article 

    • Scopus (454)

    • PubMed

    • Crossref

    • Google Scholar

    • Runyon B.A.

    • American Association for the Study of Liver Diseases

  • Identifying optimal candidates for early TIPS among patients with cirrhosis and acute variceal bleeding: a multicentre observational study.

    Gut. 2019; 68: 1297-1310

    View in Article 

    • Scopus (47)

    • PubMed

    • Crossref

    • Google Scholar

    • Lv Y.

    • Zuo L.

    • Zhu X.

    • et al.

  • Early use of TIPS in patients with cirrhosis and variceal bleeding.

    N Engl J Med. 2010; 362: 2370-2379

    View in Article 

    • Scopus (757)

    • PubMed

    • Crossref

    • Google Scholar

    • Garcia-Pagan J.C.

    • Caca K.

    • Bureau C.

    • et al.

  • Transjugular intrahepatic portosystemic shunts with covered stents increase transplant-free survival of patients with cirrhosis and recurrent ascites.

    Gastroenterology. 2017; 152: 157-163

    View in Article 

    • Scopus (177)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Bureau C.

    • Thabut D.

    • Oberti F.

    • et al.

  • Transjugular intrahepatic portosystemic shunt for symptomatic refractory hepatic hydrothorax in patients with cirrhosis.

    Am J Gastroenterol. 2010; 105: 635-641

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Dhanasekaran R.

    • West J.K.

    • Gonzales P.C.

    • et al.

  • Transjugular intrahepatic portosystemic shunt for hepatorenal syndrome: a systematic review and meta-analysis.

    Dig Liver Dis. 2018; 50: 323-330

    View in Article 

    • Scopus (35)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Song T.

    • Rossle M.

    • He F.

    • et al.

  • Effect of transjugular intrahepatic portosystemic shunt formation on portal hypertensive gastropathy and gastric circulation.

    Am J Gastroenterol. 2001; 96: 1155-1159

    View in Article 

    • PubMed

    • Crossref

    • Google Scholar

    • Mezawa S.

    • Homma H.

    • Ohta H.

    • et al.

  • National trends and outcomes of transjugular intrahepatic portosystemic shunt creation using the nationwide inpatient sample.

    J Vasc Interv Radiol. 2016; 27: 838-845

    View in Article 

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Trivedi P.S.

    • Rochon P.J.

    • Durham J.D.

    • et al.

  • Transjugular intrahepatic portosystemic shunt: impact on systemic hemodynamics and renal and cardiac function in patients with cirrhosis.

    Am J Physiol Gastrointest Liver Physiol. 2018; 314: G275-G286

    View in Article 

    • Scopus (20)

    • PubMed

    • Crossref

    • Google Scholar

    • Busk T.M.

    • Bendtsen F.

    • Poulsen J.H.

    • et al.

  • Transjugular intrahepatic portosystemic shunt using the new Gore Viatorr controlled expansion endoprosthesis: prospective, single-center, preliminary experience.

    Cardiovasc Intervent Radiol. 2019; 42: 78-86

    View in Article 

    • Scopus (31)

    • PubMed

    • Crossref

    • Google Scholar

    • Miraglia R.

    • Maruzzelli L.

    • Di Piazza A.

    • et al.

  • New techniques and devices in transjugular intrahepatic portosystemic shunt placement.

    Semin Intervent Radiol. 2018; 35: 206-214

    View in Article 

    • Scopus (5)

    • PubMed

    • Crossref

    • Google Scholar

    • RiChard J.

    • Thornburg B.

  • AGREE II: advancing guideline development, reporting and evaluation in health care.

    CMAJ. 2010; 182: E839-E842

    View in Article 

    • Scopus (1637)

    • PubMed

    • Crossref

    • Google Scholar

    • Brouwers M.C.

    • Kho M.E.

    • Browman G.P.

    • et al.

  • An experimental application of the DELPHI method to the use of experts.

    Manage Sci. 1963; 9: 458-467

    View in Article 

    • Crossref

    • Google Scholar

    • Dalkey N.

    • Helmer O.

  • The 2011 Oxford CEBM levels of evidence.

    University of Oxford, Oxford Centre for Evidence-Based Medicine, Oxford, UK2011

    View in Article 

    • Google Scholar

    • Howick J.

    • Chalmers I.

    • Glasziou P.

    • et al.

  • The role of transjugular intrahepatic portosystemic shunt (TIPS) in the management of portal hypertension: update 2009.

    Hepatology. 2010; 51: 306

    View in Article 

    • Scopus (377)

    • PubMed

    • Crossref

    • Google Scholar

    • Boyer T.D.

    • Haskal Z.J.

    • American Association for the Study of Liver Diseases

  • Quality improvement guidelines for transjugular intrahepatic portosystemic shunts.

    J Vasc Interv Radiol. 2016; 27: 1-7

    View in Article 

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Dariushnia S.R.

    • Haskal Z.J.

    • Midia M.

    • et al.

  • Prognostic capability of different liver disease scoring systems for prediction of early mortality after transjugular intrahepatic portosystemic shunt creation.

    J Vasc Interv Radiol. 2013; 24 (420.e1-4; quiz 421): 411-420

    View in Article 

    • Scopus (45)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Gaba R.C.

    • Couture P.M.

    • Bui J.T.

    • et al.

  • Hyponatremia and mortality among patients on the liver-transplant waiting list.

    N Engl J Med. 2008; 359: 1018-1026

    View in Article 

    • Scopus (822)

    • PubMed

    • Crossref

    • Google Scholar

    • Kim W.R.

    • Biggins S.W.

    • Kremers W.K.

    • et al.

  • Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis.

    Gastroenterology. 2013; 144 (1437 e1–9): 1426-1437

    View in Article 

    • Scopus (1449)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Moreau R.

    • Jalan R.

    • Gines P.

    • et al.

  • Transection of the oesophagus for bleeding oesophageal varices.

    Br J Surg. 1973; 60: 646-649

    View in Article 

    • PubMed

    • Crossref

    • Google Scholar

    • Pugh R.N.

    • Murray-Lyon I.M.

    • Dawson J.L.

    • et al.

  • Comparison of MELD, Child-Pugh, and Emory model for the prediction of survival in patients undergoing transjugular intrahepatic portosystemic shunting.

    Am J Gastroenterol. 2003; 98: 1167-1174

    View in Article 

    • Scopus (143)

    • PubMed

    • Crossref

    • Google Scholar

    • Schepke M.

    • Roth F.

    • Fimmers R.

    • et al.

  • Model for end-stage liver disease (MELD) and allocation of donor livers.

    Gastroenterology. 2003; 124: 91-96

    View in Article 

    • Scopus (1841)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Wiesner R.

    • Edwards E.

    • Freeman R.

    • et al.

  • Accuracy of MELD scores in predicting mortality in decompensated cirrhosis from variceal bleeding, hepatorenal syndrome, alcoholic hepatitis, or acute liver failure as well as mortality after non-transplant surgery or TIPS.

    Dig Dis Sci. 2011; 56: 977-987

    View in Article 

    • Scopus (61)

    • PubMed

    • Crossref

    • Google Scholar

    • Al Sibae M.R.

    • Cappell M.S.

  • Application of the model for end-stage liver disease score for transjugular intrahepatic portosystemic shunt in cirrhotic patients with refractory ascites and renal impairment.

    Eur J Gastroenterol Hepatol. 2004; 16: 607-612

    View in Article 

    • Scopus (12)

    • PubMed

    • Crossref

    • Google Scholar

    • Alessandria C.

    • Gaia S.

    • Marzano A.

    • et al.

  • Transjugular intrahepatic porto-systemic shunt in patients with liver cirrhosis and model for end-stage liver disease ≥15.

    Dig Dis Sci. 2017; 62: 534-542

    View in Article 

    • Scopus (9)

    • PubMed

    • Crossref

    • Google Scholar

    • Ascha M.

    • Hanouneh M.

    • Ascha M.

    • et al.

  • Evaluation of model performance to predict survival after transjugular intrahepatic portosystemic shunt placement.

    PLoS One. 2019; 14e0217442

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Allegretti A.S.

    • Frenk N.E.

    • Li D.K.

    • et al.

  • Survival after elective transjugular intrahepatic portosystemic shunt creation: prediction with model for end-stage liver disease score.

    Radiology. 2004; 231: 231-236

    View in Article 

    • Scopus (109)

    • PubMed

    • Crossref

    • Google Scholar

    • Ferral H.

    • Gamboa P.

    • Postoak D.W.

    • et al.

  • Short outcome comparison of elderly patients versus nonelderly patients treated with transjugular intrahepatic portosystemic stent shunt: a propensity score matched cohort study.

    Medicine (Baltimore). 2017; 96e7551

    View in Article 

    • Scopus (2)

    • PubMed

    • Crossref

    • Google Scholar

    • Li Y.

    • Wang F.

    • Chen X.

    • et al.

  • Age-related morbidity and mortality after transjugular intrahepatic portosystemic shunts.

    J Clin Gastroenterol. 2017; 51: 360-363

    View in Article 

    • Scopus (7)

    • PubMed

    • Crossref

    • Google Scholar

    • Suraweera D.

    • Jimenez M.

    • Viramontes M.

    • et al.

  • Rebleeding and mortality risk are increased by ACLF but reduced by pre-emptive TIPS.

    J Hepatol. 2020; 73: 1082-1091

    View in Article 

    • Scopus (37)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Trebicka J.

    • Gu W.

    • Ibáñez-Samaniego L.

    • et al.

  • Eight millimetre covered TIPS does not compromise shunt function but reduces hepatic encephalopathy in preventing variceal rebleeding.

    J Hepatol. 2017; 67: 508-516

    View in Article 

    • Scopus (68)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Wang Q.

    • Lv Y.

    • Bai M.

    • et al.

  • Transjugular intrahepatic portosystemic shunts in patients with cirrhosis with refractory ascites: comparison of clinical outcomes by using 8- and 10-mm PTFE-covered stents.

    Radiology. 2017; 284: 281-288

    View in Article 

    • Scopus (39)

    • PubMed

    • Crossref

    • Google Scholar

    • Miraglia R.

    • Maruzzelli L.

    • Tuzzolino F.

    • et al.

  • Nephrotoxicity of ionic and nonionic contrast media in 1196 patients: a randomized trial. The Iohexol cooperative study.

    Kidney Int. 1995; 47: 254-261

    View in Article 

    • PubMed

    • Abstract

    • Full Text PDF

    • Google Scholar

    • Rudnick M.R.

    • Goldfarb S.

    • Wexler L.

    • et al.

  • Dosing of contrast material to prevent contrast nephropathy in patients with renal disease.

    Am J Med. 1989; 86: 649-652

    View in Article 

    • Scopus (416)

    • PubMed

    • Abstract

    • Full Text PDF

    • Google Scholar

    • Cigarroa R.G.

    • Lange R.A.

    • Williams R.H.

    • et al.

  • 2013 ACCF/AHA guideline for the management of heart failure.

    J Am Coll Cardiol. 2013; 62: e147-e239

    View in Article 

    • Scopus (4186)

    • PubMed

    • Crossref

    • Google Scholar

    • Yancy C.W.

    • Jessup M.

    • Bozkurt B.

    • et al.

  • 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

    Circulation. 2021; 143: e72-e227

    View in Article 

    • PubMed

    • Google Scholar

    • Otto C.M.

    • Nishimura R.A.

    • Bonow R.O.

    • et al.

  • Evaluation for liver transplantation in adults: 2013 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation.

    Hepatology. 2014; 59: 1144-1165

    View in Article 

    • Scopus (438)

    • PubMed

    • Crossref

    • Google Scholar

    • Martin P.

    • DiMartini A.

    • Feng S.

    • et al.

  • American College of Radiology (ACR)-Society of Interventional Radiology (SIR)-Society for Pediatric Radiology (SPR) Practice Parameter for the Creation of a Transjugular Intrahepatic Portosystemic Shunt (TIPS) - ACR-SIR-SPR TIPS.

    (Available at:)

    https://www./-/media/ACR/Files/Practice-Parameters/TIPS.pdf?la=en

    Date: 2017

    Date accessed: October 23, 2020

    View in Article 

    • Google Scholar

    • Society of Interventional Radiology Standards of Practice Committee

  • Polytetrafluoroethylene-covered stent grafts for TIPS procedure: 1-year patency and clinical results.

    Am J Gastroenterol. 2004; 99: 280-285

    View in Article 

    • Scopus (65)

    • PubMed

    • Crossref

    • Google Scholar

    • Angeloni S.

    • Merli M.

    • Salvatori F.M.

    • et al.

  • Comparison of transjugular intrahepatic portosystemic shunt dysfunction in PTFE-covered stent-grafts versus bare stents.

    Eur J Radiol. 2005; 55: 120-124

    View in Article 

    • Scopus (0)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Barrio J.

    • Ripoll C.

    • Bañares R.

    • et al.

  • Results of a retrospective multicenter trial of the Viatorr expanded polytetrafluoroethylene-covered stent-graft for transjugular intrahepatic portosystemic shunt creation.

    J Vasc Interv Radiol. 2004; 15: 1219-1230

    View in Article 

    • Scopus (98)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Charon J.P.

    • Alaeddin F.H.

    • Pimpalwar S.A.

    • et al.

  • Transjugular intrahepatic portosystemic shunt creation with the Viatorr expanded polytetrafluoroethylene-covered stent-graft.

    J Vasc Interv Radiol. 2004; 15: 239-248

    View in Article 

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Hausegger K.A.

    • Karnel F.

    • Georgieva B.

    • et al.

  • Preliminary results of a new expanded-polytetrafluoroethylene-covered stent-graft for transjugular intrahepatic portosystemic shunt procedures.

    AJR Am J Roentgenol. 2002; 178: 141-147

    View in Article 

    • PubMed

    • Crossref

    • Google Scholar

    • Otal P.

    • Smayra T.

    • Bureau C.

    • et al.

  • Covered vs. uncovered stents for transjugular intrahepatic portosystemic shunt: a randomized controlled trial.

    J Hepatol. 2014; 60: 962-968

    View in Article 

    • Scopus (114)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Perarnau J.M.

    • Le Gouge A.

    • Nicolas C.

    • et al.

  • Clinical efficacy of transjugular intrahepatic portosystemic shunt created with covered stents with different diameters: results of a randomized controlled trial.

    J Hepatol. 2010; 53: 267-272

    View in Article 

    • Scopus (94)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Riggio O.

    • Ridola L.

    • Angeloni S.

    • et al.

  • Improved clinical outcome with transjugular intrahepatic portosystemic stent-shunt utilizing polytetrafluoroethylene-covered stents.

    Eur J Gastroenterol Hepatol. 2006; 18: 225-232

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Tripathi D.

    • Ferguson J.

    • Barkell H.

    • et al.

  • Stent-grafts for transjugular intrahepatic portosystemic shunt creation: specialized TIPS stent-graft versus generic stent-graft/bare stent combination.

    J Vasc Interv Radiol. 2010; 21: 1512-1520

    View in Article 

    • Scopus (34)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Saad W.E.

    • Darwish W.M.

    • Davies M.G.

    • et al.

  • Prospective evaluation of passive expansion of partially dilated transjugular intrahepatic portosystemic shunt stent grafts-a three-dimensional sonography study.

    J Vasc Interv Radiol. 2017; 28: 117-125

    View in Article 

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Pieper C.C.

    • Jansen C.

    • Meyer C.

    • et al.

  • Postinterventional passive expansion of partially dilated transjugular intrahepatic portosystemic shunt stents.

    J Vasc Interv Radiol. 2015; 26: 388-394

    View in Article 

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Pieper C.C.

    • Sprinkart A.M.

    • Nadal J.

    • et al.

  • Vascular liver disorders, portal vein thrombosis, and procedural bleeding in patients with liver disease: 2020 Practice Guidance by the American Association for the Study of Liver Diseases.

    Hepatology. 2021; 73: 366-413

    View in Article 

    • Scopus (46)

    • PubMed

    • Crossref

    • Google Scholar

    • Northup P.G.

    • Garcia-Pagan J.C.

    • Garcia-Tsao G.

    • et al.

  • Thrombelastography-guided blood product use before invasive procedures in cirrhosis with severe coagulopathy: a randomized, controlled trial.

    Hepatology. 2016; 63: 566-573

    View in Article 

    • Scopus (214)

    • PubMed

    • Crossref

    • Google Scholar

    • De Pietri L.

    • Bianchini M.

    • Montalti R.

    • et al.

  • Bleeding after invasive procedures is rare and unpredicted by platelet counts in cirrhotic patients with thrombocytopenia.

    Eur J Intern Med. 2017; 38: 79-82

    View in Article 

    • Scopus (60)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Napolitano G.

    • Iacobellis A.

    • Merla A.

    • et al.

  • The coagulopathy of chronic liver disease.

    N Engl J Med. 2011; 365: 147-156

    View in Article 

    • Scopus (866)

    • PubMed

    • Crossref

    • Google Scholar

    • Tripodi A.

    • Mannucci P.M.

  • Evidence of normal thrombin generation in cirrhosis despite abnormal conventional coagulation tests.

    Hepatology. 2005; 41: 553-558

    View in Article 

    • Scopus (496)

    • PubMed

    • Crossref

    • Google Scholar

    • Tripodi A.

    • Salerno F.

    • Chantarangkul V.

    • et al.

  • Paucity of studies to support that abnormal coagulation test results predict bleeding in the setting of invasive procedures: an evidence-based review.

    Transfusion. 2005; 45: 1413-1425

    View in Article 

    • Scopus (505)

    • PubMed

    • Crossref

    • Google Scholar

    • Segal J.B.

    • Dzik W.H.

    • Transfusion Medicine/Hemostasis Clinical Trials Network

  • Endotipsitis: a case report with a literature review on an emerging prosthetic related infection.

    World J Hepatol. 2015; 7: 710-716

    View in Article 

    • Scopus (14)

    • PubMed

    • Crossref

    • Google Scholar

    • Navaratnam A.M.

    • Grant M.

    • Banach D.B.

  • Endotipsitis-persistent infection of transjugular intrahepatic portosystemic shunt: pathogenesis, clinical features and management.

    Liver Int. 2010; 30: 175-183

    View in Article 

    • Scopus (25)

    • PubMed

    • Crossref

    • Google Scholar

    • Mizrahi M.

    • Adar T.

    • Shouval D.

    • et al.

  • Intravascular ultrasound in the creation of transhepatic portosystemic shunts reduces needle passes, radiation dose, and procedure time: a retrospective study of a single-institution experience.

    J Vasc Interv Radiol. 2016; 27: 1148-1153

    View in Article 

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Kao S.D.

    • Morshedi M.M.

    • Narsinh K.H.

    • et al.

  • Utility of intravascular US-guided portal vein access during transjugular intrahepatic portosystemic shunt creation: retrospective comparison with conventional technique in 109 patients.

    J Vasc Interv Radiol. 2016; 27: 1154-1159

    View in Article 

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Pillai A.K.

    • Andring B.

    • Faulconer N.

    • et al.

  • Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis.

    Gastroenterology. 2007; 133: 481-488

    View in Article 

    • Scopus (671)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Ripoll C.

    • Groszmann R.

    • Garcia-Tsao G.

    • et al.

  • Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies.

    J Hepatol. 2006; 44: 217-231

    View in Article 

    • Scopus (1702)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • D'Amico G.

    • Garcia-Tsao G.

    • Pagliaro L.

  • Timing affects measurement of portal pressure gradient after placement of transjugular intrahepatic portosystemic shunts in patients with portal hypertension.

    Gastroenterology. 2017; 152: 1358-1365

    View in Article 

    • Scopus (34)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Silva-Junior G.

    • Turon F.

    • Baiges A.

    • et al.

  • Clinical events after transjugular intrahepatic portosystemic shunt: correlation with hemodynamic findings.

    Gastroenterology. 1998; 114: 1296-1303

    View in Article 

    • Scopus (329)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Casado M.

    • Bosch J.

    • Garcia-Pagan J.C.

    • et al.

  • Right atrial pressure is not adequate to calculate portal pressure gradient in cirrhosis: a clinical-hemodynamic correlation study.

    Hepatology. 2010; 51: 2108-2116

    View in Article 

    • Scopus (54)

    • PubMed

    • Crossref

    • Google Scholar

    • La Mura V.

    • Abraldes J.G.

    • Berzigotti A.

    • et al.

  • Is transjugular intrahepatic portosystemic shunt really deleterious for liver transplantation issue? A monocentric study on 86 liver transplanted patients.

    Transplant Proc. 2001; 33: 3468-3469

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Castellani P.

    • Campan P.

    • Bernardini D.

    • et al.

  • Impact of transjugular intrahepatic portosystemic shunt on orthotopic liver transplantation.

    World J Surg. 1994; 18 (discussion 870–871): 866-870

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Menegaux F.

    • Baker E.

    • Keeffe E.B.

    • et al.

  • Can pretransplant TIPS be harmful in liver transplantation? A propensity score matching analysis.

    Surgery. 2020; 168: 33-39

    View in Article 

    • Scopus (2)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Matsushima H.

    • Fujiki M.

    • Sasaki K.

    • et al.

  • Transjugular intrahepatic portosystemic shunts: impact on liver transplantation.

    Liver Transpl Surg. 1995; 1: 229-233

    View in Article 

    • PubMed

    • Crossref

    • Google Scholar

    • Millis J.M.

    • Martin P.

    • Gomes A.

    • et al.

  • Hemodynamic and metabolic effects of transjugular intrahepatic portosystemic shunt (TIPS) during anesthesia for orthotopic liver transplantation.

    Transpl Int. 1996; 9: 403-407

    View in Article 

    • PubMed

    • Crossref

    • Google Scholar

    • Antonini M.

    • Della Rocca G.

    • Pugliese F.

    • et al.

  • Covered transjugular intrahepatic portosystemic shunts: accuracy of ultrasound in detecting shunt malfunction.

    AJR Am J Roentgenol. 2013; 200: 904-908

    View in Article 

    • PubMed

    • Crossref

    • Google Scholar

    • Engstrom B.I.

    • Horvath J.J.

    • Suhocki P.V.

    • et al.

  • Transjugular intrahepatic portosystemic shunt dysfunction: concordance of clinical findings, Doppler ultrasound examination, and shunt venography.

    J Clin Imaging Sci. 2016; 6: 29

    View in Article 

    • Scopus (12)

    • PubMed

    • Crossref

    • Google Scholar

    • Owen J.M.

    • Gaba R.C.

  • Performance of ultrasound for detection of transjugular intrahepatic portosystemic shunt dysfunction: a meta-analysis.

    Abdom Radiol (NY). 2019; 44: 2392-2402

    View in Article 

    • Scopus (7)

    • PubMed

    • Crossref

    • Google Scholar

    • Manatsathit W.

    • Samant H.

    • Panjawatanan P.

    • et al.

  • Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis and management - 2016 Practice Guidance by the American Association for the Study of Liver Diseases.

    Hepatology. 2017; 65: 310-335

    View in Article 

    • Scopus (763)

    • PubMed

    • Crossref

    • Google Scholar

    • Garcia-Tsao G.

    • Abraldes J.

    • Berzigotti A.

    • et al.

  • Pretransplantation portal vein recanalization and transjugular intrahepatic portosystemic shunt creation for chronic portal vein thrombosis: final analysis of a 61-patient cohort.

    J Vasc Interv Radiol. 2017; 28: 1714-1721.e2

    View in Article 

    • Scopus (47)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Thornburg B.

    • Desai K.

    • Hickey R.

    • et al.

  • Transjugular intrahepatic portosystemic shunts: comparison with paracentesis in patients with cirrhosis and refractory ascites: a randomized trial. French Group of Clinicians and a Group of Biologists.

    J Hepatol. 1996; 25: 135-144

    View in Article 

    • Scopus (373)

    • PubMed

    • Abstract

    • Full Text PDF

    • Google Scholar

    • Lebrec D.

    • Giuily N.

    • Hadengue A.

    • et al.

  • A comparison of paracentesis and transjugular intrahepatic portosystemic shunting in patients with ascites.

    N Engl J Med. 2000; 342: 1701-1707

    View in Article 

    • Scopus (466)

    • PubMed

    • Crossref

    • Google Scholar

    • Rössle M.

    • Ochs A.

    • Gülberg V.

    • et al.

  • Transjugular intrahepatic portosystemic shunting versus paracentesis plus albumin for refractory ascites in cirrhosis.

    Gastroenterology. 2002; 123: 1839-1847

    View in Article 

    • Scopus (425)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Ginès P.

    • Uriz J.

    • Calahorra B.

    • et al.

  • The North American Study for the treatment of refractory ascites.

    Gastroenterology. 2003; 124: 634-641

    View in Article 

    • Scopus (333)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Sanyal A.J.

    • Genning C.

    • Reddy K.R.

    • et al.

  • Randomized controlled study of TIPS versus paracentesis plus albumin in cirrhosis with severe ascites.

    Hepatology. 2004; 40: 629-635

    View in Article 

    • Scopus (278)

    • PubMed

    • Crossref

    • Google Scholar

    • Salerno F.

    • Merli M.

    • Riggio O.

    • et al.

  • Transjugular intrahepatic portosystemic shunt versus paracentesis plus albumin in patients with refractory ascites who have good hepatic and renal function: a prospective randomized trial.

    J Gastroenterol. 2011; 46: 78-85

    View in Article 

    • Scopus (96)

    • PubMed

    • Crossref

    • Google Scholar

    • Narahara Y.

    • Kanazawa H.

    • Fukuda T.

    • et al.

  • Transjugular intrahepatic portosystemic shunt in refractory ascites: a meta-analysis.

    Liver Int. 2005; 25: 349-356

    View in Article 

    • Scopus (93)

    • PubMed

    • Crossref

    • Google Scholar

    • Deltenre P.

    • Mathurin P.

    • Dharancy S.

    • et al.

  • Uncovered transjugular intrahepatic portosystemic shunt for refractory ascites: a meta-analysis.

    Gastroenterology. 2005; 129: 1282-1293

    View in Article 

    • Scopus (165)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • D'Amico G.

    • Luca A.

    • Morabito A.

    • et al.

  • A meta-analysis of transjugular intrahepatic portosystemic shunt versus paracentesis for refractory ascites.

    J Hepatol. 2005; 43: 990-996

    View in Article 

    • Scopus (0)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Albillos A.

    • Bañares R.

    • González M.

    • et al.

  • Transjugular intrahepatic portosystemic shunt for refractory ascites: a meta-analysis of individual patient data.

    Gastroenterology. 2007; 133: 825-834

    View in Article 

    • Scopus (370)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Salerno F.

    • Cammà C.

    • Enea M.

    • et al.

  • TIPS improves liver transplantation-free survival in cirrhotic patients with refractory ascites: an updated meta-analysis.

    World J Gastroenterol. 2014; 20: 2704-2714

    View in Article 

    • Scopus (73)

    • PubMed

    • Crossref

    • Google Scholar

    • Bai M.

    • Qi X.S.

    • Yang Z.P.

    • et al.

  • TIPS versus paracentesis for cirrhotic patients with refractory ascites.

    Cochrane Database Syst Rev. 2006; 4: CD004889

    View in Article 

    • PubMed

    • Google Scholar

    • Saab S.

    • Nieto J.M.

    • Lewis S.K.

    • et al.

  • Safety and efficacy of transjugular intrahepatic portosystemic shunt creation for the treatment of hepatic hydrothorax.

    J Vasc Interv Radiol. 2002; 13: 385-390

    View in Article 

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Spencer E.B.

    • Cohen D.T.

    • Darcy M.D.

  • Transjugular intrahepatic portosystemic shunt (TIPS) placement: a comparison of outcomes between patients with hepatic hydrothorax and patients with refractory ascites.

    Diagn Interv Imaging. 2019; 100: 303-308

    View in Article 

    • Scopus (8)

    • PubMed

    • Crossref

    • Google Scholar

    • Young S.

    • Bermudez J.

    • Zhang L.

    • et al.

  • Treatment of refractory hepatic hydrothorax with transjugular intrahepatic portosystemic shunt: long-term results in 40 patients.

    Eur J Gastroenterol Hepatol. 2001; 13: 529-534

    View in Article 

    • Scopus (153)

    • PubMed

    • Crossref

    • Google Scholar

    • Siegerstetter V.

    • Deibert P.

    • Ochs A.

    • et al.

  • The outcome after transjugular intrahepatic portosystemic shunt (TIPS) for hepatic hydrothorax is closely related to liver dysfunction: a long-term study in 28 patients.

    Acta Gastroenterol Belg. 2007; 70: 6-10

    View in Article 

    • PubMed

    • Google Scholar

    • Wilputte J.Y.

    • Goffette P.

    • Zech F.

    • et al.

  • The successful treatment of symptomatic, refractory hepatic hydrothorax with transjugular intrahepatic portosystemic shunt.

    Hepatology. 1997; 25: 1366-1369

    View in Article 

    • Scopus (197)

    • PubMed

    • Crossref

    • Google Scholar

    • Gordon F.D.

    • Anastopoulos H.T.

    • Crenshaw W.

    • et al.

  • Transjugular intrahepatic portosystemic shunts in liver transplant recipients for management of refractory ascites: clinical outcome.

    J Vasc Interv Radiol. 2010; 21: 218-223

    View in Article 

    • Scopus (0)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Saad W.E.

    • Darwish W.M.

    • Davies M.G.

    • et al.

  • A case-controlled study of the safety and efficacy of transjugular intrahepatic portosystemic shunts after liver transplantation.

    Liver Transpl. 2011; 17: 771-778

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • King A.

    • Masterton G.

    • Gunson B.

    • et al.

  • Transjugular intrahepatic portosystemic shunts in liver transplant recipients: technical analysis and clinical outcome.

    AJR Am J Roentgenol. 2013; 200: 210-218

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Saad W.E.

    • Darwish W.M.

    • Davies M.G.

    • et al.

  • The mechanism of the initial natriuresis after transjugular intrahepatic portosystemic shunt.

    Gastroenterology. 1997; 112: 899-907

    View in Article 

    • Scopus (88)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Wong F.

    • Sniderman K.

    • Liu P.

    • et al.

  • Influence of portal hypertension and its early decompression by TIPS placement on the outcome of variceal bleeding.

    Hepatology. 2004; 40: 793-801

    View in Article 

    • Scopus (367)

    • PubMed

    • Crossref

    • Google Scholar

    • Monescillo A.

    • Martinez-Lagares F.

    • Ruiz-del-Arbol L.

    • et al.

  • Early TIPS with covered stents versus standard treatment for acute variceal bleeding in patients with advanced cirrhosis: a randomised controlled trial.

    Lancet Gastroenterol Hepatol. 2019; 4: 587-598

    View in Article 

    • Scopus (54)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Lv Y.

    • Yang Z.

    • Liu L.

    • et al.

  • Use of early-TIPS for high-risk variceal bleeding: results of a post-RCT surveillance study.

    J Hepatol. 2013; 58: 45-50

    View in Article 

    • Scopus (178)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Garcia-Pagan J.C.

    • Di P.M.

    • Caca K.

    • et al.

  • Early-TIPSS placement prevents rebleeding in high-risk patients with variceal bleeding, without improving survival.

    Aliment Pharmacol Ther. 2014; 40: 1074-1080

    View in Article 

    • Scopus (79)

    • PubMed

    • Crossref

    • Google Scholar

    • Rudler M.

    • Cluzel P.

    • Corvec T.L.

    • et al.

  • Re-bleeding rates and survival after early transjugular intrahepatic portosystemic shunt (TIPS) in clinical practice.

    Dig Liver Dis. 2017; 49: 1360-1367

    View in Article 

    • Scopus (13)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Bucsics T.

    • Schoder M.

    • Goeschl N.

    • et al.

  • Preemptive-TIPS improves outcome in high-risk variceal bleeding: an observational study.

    Hepatology. 2019; 69: 282-293

    View in Article 

    • Scopus (2)

    • PubMed

    • Crossref

    • Google Scholar

    • Hernández-Gea V.

    • Procopet B.

    • Giráldez Á.

    • et al.

  • Transjugular intrahepatic portosystemic shunt creation and variceal coil or plug embolization ineffectively attain gastric variceal decompression or occlusion: results of a 26-patient retrospective study.

    J Vasc Interv Radiol. 2016; 27: 1001-1011

    View in Article 

    • Scopus (17)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Lakhoo J.

    • Bui J.T.

    • Lokken R.P.

    • et al.

  • Comparison of transjugular intrahepatic portosystemic shunt (TIPS) alone and combined with embolisation for the management of cardiofundal varices: a retrospective study.

    Eur Radiol. 2019; 29: 699-706

    View in Article 

    • Scopus (9)

    • PubMed

    • Crossref

    • Google Scholar

    • Yu J.

    • Wang X.

    • Jiang M.

    • et al.

  • The combination of balloon-assisted antegrade transvenous obliteration and transjugular intrahepatic portosystemic shunt for the management of cardiofundal varices hemorrhage.

    Eur J Gastroenterol Hepatol. 2020; 32: 656-662

    View in Article 

    • Scopus (5)

    • PubMed

    • Crossref

    • Google Scholar

    • Liu J.

    • Yang C.

    • Huang S.

    • et al.

  • Comparison of transjugular intrahepatic portosystemic shunt (TIPS) alone versus TIPS combined with embolotherapy in advanced cirrhosis: a retrospective study.

    J Clin Gastroenterol. 2011; 45: 643-650

    View in Article 

    • Scopus (28)

    • PubMed

    • Crossref

    • Google Scholar

    • Xiao T.

    • Chen L.

    • Chen W.

    • et al.

  • Prognostic role of the initial portal pressure gradient reduction after TIPS in patients with cirrhosis.

    Eur J Gastroenterol Hepatol. 2007; 19: 846-852

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Biecker E.

    • Roth F.

    • Heller J.

    • et al.

  • How much reduction in portal pressure is necessary to prevent variceal rebleeding? A longitudinal study in 225 patients with transjugular intrahepatic portosystemic shunts.

    Am J Gastroenterol. 2001; 96: 3379-3383

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Rössle M.

    • Siegerstetter V.

    • Olschewski M.

    • et al.

  • Gastric varices bleed at lower portosystemic pressure gradients than esophageal varices.

    J Vasc Interv Radiol. 2018; 29: 636-641

    View in Article 

    • Scopus (10)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Morrison J.D.

    • Mendoza-Elias N.

    • Lipnik A.J.

    • et al.

  • Root cause analysis of rebleeding events following transjugular intrahepatic portosystemic shunt creation for variceal hemorrhage.

    J Vasc Interv Radiol. 2015; 26: 1444-1453

    View in Article 

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Lakhoo J.

    • Bui J.T.

    • Zivin S.P.

    • et al.

  • Transjugular intrahepatic portosystemic shunt in combination with or without variceal embolization for the prevention of variceal rebleeding: a meta-analysis.

    J Gastroenterol Hepatol. 2014; 29: 688-696

    View in Article 

    • Scopus (45)

    • PubMed

    • Crossref

    • Google Scholar

    • Qi X.

    • Liu L.

    • Bai M.

    • et al.

  • Transjugular intrahepatic portosystemic shunts: adjunctive embolotherapy of gastroesophageal collateral vessels in the prevention of variceal rebleeding.

    Radiology. 2005; 236: 360-367

    View in Article 

    • Scopus (90)

    • PubMed

    • Crossref

    • Google Scholar

    • Tesdal I.K.

    • Filser T.

    • Weiss C.

    • et al.

  • Recurrent variceal bleeding and shunt patency: prospective randomized controlled trial of transjugular intrahepatic portosystemic shunt alone or combined with coronary vein embolization.

    Radiology. 2013; 268: 900-906

    View in Article 

    • Scopus (50)

    • PubMed

    • Crossref

    • Google Scholar

    • Chen S.

    • Li X.

    • Wei B.

    • et al.

  • TIPS for treatment of variceal hemorrhage: clinical outcomes in 128 patients at a single institution over a 12-year period.

    J Vasc Interv Radiol. 2012; 23: 227-235

    View in Article 

    • Scopus (57)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Gaba R.C.

    • Omene B.O.

    • Podczerwinski E.S.

    • et al.

  • Efficacy of transjugular intrahepatic portosystemic shunt with adjunctive embolotherapy with cyanoacrylate for esophageal variceal bleeding.

    Dig Dis Sci. 2014; 59: 2325-2332

    View in Article 

    • Scopus (19)

    • PubMed

    • Crossref

    • Google Scholar

    • Shi Y.

    • Tian X.

    • Hu J.

    • et al.

  • Hemodynamic effects of propranolol and nitrates in cirrhotics with transjugular intrahepatic portosystemic stent-shunt.

    Scand J Gastroenterol. 2002; 37: 1070-1076

    View in Article 

    • Scopus (15)

    • PubMed

    • Crossref

    • Google Scholar

    • Brensing K.A.

    • Hörsch M.

    • Textor J.

    • et al.

  • Transjugular intrahepatic portosystemic shunt before abdominal surgery in cirrhotic patients: a retrospective, comparative study.

    Can J Gastroenterol. 2006; 20: 401-404

    View in Article 

    • Scopus (37)

    • PubMed

    • Crossref

    • Google Scholar

    • Vinet E.

    • Perreault P.

    • Bouchard L.

    • et al.

  • Original study: transjugular intrahepatic portosystemic shunt as a bridge to abdominal surgery in cirrhotic patients.

    J Gastrointest Surg. 2019; 23: 2383-2390

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Tabchouri N.

    • Barbier L.

    • Menahem B.

    • et al.

  • When and why portal vein thrombosis matters in liver transplantation: a critical audit of 174 cases.

    Ann Surg. 2014; 259: 760-766

    View in Article 

    • Scopus (89)

    • PubMed

    • Crossref

    • Google Scholar

    • Hibi T.

    • Nishida S.

    • Levi D.M.

    • et al.

  • Systematic review with meta-analysis: portal vein recanalisation and transjugular intrahepatic portosystemic shunt for portal vein thrombosis.

    Aliment Pharmacol Ther. 2019; 49: 20-30

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Rodrigues S.G.

    • Sixt S.

    • Abraldes J.G.

    • et al.

  • The role of transjugular intrahepatic portosystemic shunt in the management of portal vein thrombosis: a systematic review and meta-analysis.

    Eur J Gastroenterol Hepatol. 2018; 30: 1187-1193

    View in Article 

    • Scopus (21)

    • PubMed

    • Crossref

    • Google Scholar

    • Valentin N.

    • Korrapati P.

    • Constantino J.

    • et al.

  • Ten-year experience of transjugular intrahepatic portosystemic shunt for noncirrhotic portal hypertension.

    Eur J Gastroenterol Hepatol. 2018; 30: 557-562

    View in Article 

    • Scopus (8)

    • PubMed

    • Crossref

    • Google Scholar

    • Regnault D.

    • d'Alteroche L.

    • Nicolas C.

    • et al.

  • TIPSS for variceal bleeding in patients with idiopathic non-cirrhotic portal hypertension: comparison with patients who have cirrhosis.

    Aliment Pharmacol Ther. 2019; 49: 926-939

    View in Article 

    • Scopus (9)

    • PubMed

    • Crossref

    • Google Scholar

    • Lv Y.

    • Li K.

    • He C.

    • et al.

  • Role of the transjugular intrahepatic portosystemic shunt in the management of severe complications of portal hypertension in idiopathic noncirrhotic portal hypertension.

    Hepatology. 2016; 64: 224-231

    View in Article 

    • Scopus (34)

    • PubMed

    • Crossref

    • Google Scholar

    • Bissonnette J.

    • Garcia-Pagan J.C.

    • Albillos A.

    • et al.

  • Budd-Chiari syndrome/hepatic venous outflow tract obstruction.

    Hepatol Int. 2018; 12: 168-180

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Valla D.C.

  • Changing spectrum of Budd-Chiari syndrome in India with special reference to non-surgical treatment.

    World J Gastroenterol. 2008; 14: 278-285

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Amarapurkar D.N.

    • Punamiya S.J.

    • Patel N.D.

  • Treatment of Budd-Chiari syndrome in a liver transplant unit, the role of transjugular intrahepatic porto-systemic shunt and liver transplantation.

    Aliment Pharmacol Ther. 2004; 20: 867-873

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Attwell A.

    • Ludkowski M.

    • Nash R.

    • et al.

  • Etiology, management, and outcome of the Budd-Chiari syndrome.

    Ann Intern Med. 2009; 151: 167-175

    View in Article 

    • PubMed

    • Crossref

    • Google Scholar

    • Darwish Murad S.

    • Plessier A.

    • Hernandez-Guerra M.

    • et al.

  • Aiming at minimal invasiveness as a therapeutic strategy for Budd-Chiari syndrome.

    Hepatology. 2006; 44: 1308-1316

    View in Article 

    • Scopus (197)

    • PubMed

    • Crossref

    • Google Scholar

    • Plessier A.

    • Sibert A.

    • Consigny Y.

    • et al.

  • Hepatic venous outflow tract obstruction: treatment outcomes and development of a new prognostic score.

    Aliment Pharmacol Ther. 2016; 43: 1154-1167

    View in Article 

    • Scopus (21)

    • PubMed

    • Crossref

    • Google Scholar

    • Shalimar Kumar A.

    • Kedia S.

    • et al.

  • Budd-Chiari syndrome: long term success via hepatic decompression using transjugular intrahepatic porto-systemic shunt.

    BMC Gastroenterol. 2010; 10: 25

    View in Article 

    • Scopus (33)

    • PubMed

    • Crossref

    • Google Scholar

    • Zahn A.

    • Gotthardt D.

    • Weiss K.H.

    • et al.

  • Good long-term outcome of Budd-Chiari syndrome with a step-wise management.

    Hepatology. 2013; 57: 1962-1968

    View in Article 

    • Scopus (173)

    • PubMed

    • Crossref

    • Google Scholar

    • Seijo S.

    • Plessier A.

    • Hoekstra J.

    • et al.

  • Outcome of non surgical hepatic decompression procedures in Egyptian patients with Budd-Chiari.

    World J Gastroenterol. 2011; 17: 906-913

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Eldorry A.

    • Barakat E.

    • Abdella H.

    • et al.

  • Long-term outcome and analysis of dysfunction of transjugular intrahepatic portosystemic shunt placement in chronic primary Budd-Chiari syndrome.

    Radiology. 2017; 283: 280-292

    View in Article 

    • Scopus (32)

    • PubMed

    • Crossref

    • Google Scholar

    • Hayek G.

    • Ronot M.

    • Plessier A.

    • et al.

  • Anatomic recanalization of hepatic vein and inferior vena cava versus direct intrahepatic portosystemic shunt creation in Budd-Chiari syndrome: overall outcome and midterm transplant-free survival.

    J Vasc Interv Radiol. 2018; 29: 790-799

    View in Article 

    • Scopus (0)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Mukund A.

    • Mittal K.

    • Mondal A.

    • et al.

  • Symptomatic heart failure after transjugular intrahepatic portosystemic shunt placement: incidence, outcomes, and predictors.

    Cardiovasc Intervent Radiol. 2018; 41: 564-571

    View in Article 

    • Scopus (10)

    • PubMed

    • Crossref

    • Google Scholar

    • Modha K.

    • Kapoor B.

    • Lopez R.

    • et al.

  • A prospective study identifying predictive factors of cardiac decompensation after transjugular intrahepatic portosystemic shunt: the Toulouse algorithm.

    Hepatology. 2019; 70: 1928-1941

    View in Article 

    • Scopus (24)

    • PubMed

    • Crossref

    • Google Scholar

    • Billey C.

    • Billet S.

    • Robic M.A.

    • et al.

  • Effects of transjugular intrahepatic portasystemic shunt (TIPS) on splanchnic and systemic hemodynamics, and hepatic function in patients with portal hypertension. Preliminary results.

    Dig Dis Sci. 1995; 40: 2121-2127

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Rodríguez-Laiz J.M.

    • Bañares R.

    • Echenagusia A.

    • et al.

  • Redefining cirrhotic cardiomyopathy for the modern era.

    Hepatology. 2020; 71: 334-345

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Izzy M.

    • VanWagner L.B.

    • Lin G.

    • et al.

  • Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.

    J Am Soc Echocardiogr. 2015; 28: 1-39.e14

    View in Article 

    • Scopus (5472)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Lang R.M.

    • Badano L.P.

    • Mor-Avi V.

    • et al.

  • Left ventricular longitudinal contractility predicts acute-on-chronic liver failure development and mortality after transjugular intrahepatic portosystemic shunt.

    Hepatol Commun. 2019; 3: 340-347

    View in Article 

    • PubMed

    • Crossref

    • Google Scholar

    • Jansen C.

    • Schröder A.

    • Schueler R.

    • et al.

  • Diastolic dysfunction is associated with poor survival in patients with cirrhosis with transjugular intrahepatic portosystemic shunt.

    Gut. 2007; 56: 869-875

    View in Article 

    • Scopus (160)

    • PubMed

    • Crossref

    • Google Scholar

    • Cazzaniga M.

    • Salerno F.

    • Pagnozzi G.

    • et al.

  • A retrospective analysis of the impact of diastolic dysfunction on one-year mortality after transjugular intrahepatic porto-systemic shunt, liver transplantation and non-transplant abdominal surgery in patients with cirrhosis.

    Ann Gastroenterol. 2015; 28: 385-390

    View in Article 

    • PubMed

    • Google Scholar

    • Shounak M.

    • Vimal R.

    • Colin S.

    • et al.

  • International Liver Transplant Society Practice Guidelines: diagnosis and management of hepatopulmonary syndrome and portopulmonary hypertension.

    Transplantation. 2016; 100: 1440-1452

    View in Article 

    • Scopus (164)

    • PubMed

    • Crossref

    • Google Scholar

    • Krowka M.J.

    • Fallon M.B.

    • Kawut S.M.

    • et al.

  • The myths and realities of portopulmonary hypertension.

    Hepatology. 2020; 72: 1455-1460

    View in Article 

    • Scopus (4)

    • PubMed

    • Crossref

    • Google Scholar

    • DuBrock H.M.

    • Krowka M.J.

  • Right atrial pressure may impact early survival of patients undergoing transjugular intrahepatic portosystemic shunt creation.

    Ann Hepatol. 2014; 13: 411-419

    View in Article 

    • PubMed

    • Crossref

    • Google Scholar

    • Parvinian A.

    • Bui J.T.

    • Grace Knuttinen M.

    • et al.

  • Circulatory response to volume expansion and transjugular intrahepatic portosystemic shunt in refractory ascites: relationship with diastolic dysfunction.

    Dig Liver Dis. 2015; 47: 1052-1058

    View in Article 

    • Scopus (9)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Filì D.

    • Falletta C.

    • Luca A.

    • et al.

  • Effects of transjugular intrahepatic portosystemic shunt (TIPS) on blood volume distribution in patients with cirrhosis.

    Dig Liver Dis. 2017; 49: 1353-1359

    View in Article 

    • Scopus (1)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Busk T.M.

    • Bendtsen F.

    • Henriksen J.H.

    • et al.

  • Predictors of mortality after transjugular portosystemic shunt.

    World J Hepatol. 2016; 8: 520-529

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Ascha M.

    • Abuqayyas S.

    • Hanouneh I.

    • et al.

  • Role of transjugular intrahepatic portosystemic shunts in the management of hepatopulmonary syndrome: a systemic literature review.

    J Vasc Interv Radiol. 2015; 26: 1266-1271

    View in Article 

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Tsauo J.

    • Weng N.

    • Ma H.

    • et al.

  • Changes in arterial oxygenation after portal decompression in Budd-Chiari syndrome patients with hepatopulmonary syndrome.

    Eur Radiol. 2019; 29: 3273-3280

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Tsauo J.

    • Zhao H.

    • Zhang X.

    • et al.

  • Clinical efficacy of transjugular intrahepatic portosystemic shunt in the treatment of hepatopulmonary syndrome.

    Medicine (Baltimore). 2017; 96e9080

    View in Article 

    • Scopus (4)

    • PubMed

    • Crossref

    • Google Scholar

    • Zhao H.

    • Liu F.

    • Yue Z.

    • et al.

  • Smaller-diameter covered transjugular intrahepatic portosystemic shunt stents are associated with increased survival.

    Clin Gastroenterol Hepatol. 2019; 17: 2793-2799 e1

    View in Article 

    • Scopus (30)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Trebicka J.

    • Bastgen D.

    • Byrtus J.

    • et al.

  • Short-term effects of transjugular intrahepatic shunt on cardiac function assessed by cardiac MRI: preliminary results.

    Cardiovasc Intervent Radiol. 2010; 33: 290-296

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Kovacs A.

    • Schepke M.

    • Heller J.

    • et al.

  • The effects of transjugular intrahepatic portosystemic stent shunt on systemic cardiocirculatory parameters.

    J Crit Care. 2014; 29: 1001-1005

    View in Article 

    • PubMed

    • Crossref

    • Google Scholar

    • Saugel B.

    • Mair S.

    • Meidert A.S.

    • et al.

  • Transjugular intrahepatic portosystemic shunt is associated with significant changes in mitral inflow parameters.

    Ann Hepatol. 2013; 12: 464-470

    View in Article 

    • PubMed

    • Crossref

    • Google Scholar

    • Pudil R.

    • Praus R.

    • Hulek P.

    • et al.

  • Transjugular intrahepatic portosystemic shunt: short-term and long-term effects on hepatic and systemic hemodynamics in patients with cirrhosis.

    Hepatology. 1999; 29: 632-639

    View in Article 

    • PubMed

    • Crossref

    • Google Scholar

    • Lotterer E.

    • Wengert A.

    • Fleig W.E.

  • Modifications of cardiac function in cirrhotic patients treated with transjugular intrahepatic portosystemic shunt (TIPS).

    Am J Gastroenterol. 2002; 97: 142-148

    View in Article 

    • PubMed

    • Crossref

    • Google Scholar

    • Merli M.

    • Valeriano V.

    • Funaro S.

    • et al.

  • Effect of transjugular intrahepatic portosystemic shunt placement on renal function: a 7-year, single-center experience.

    J Vasc Interv Radiol. 2010; 21: 1370-1376

    View in Article 

    • Scopus (34)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Anderson C.L.

    • Saad W.E.

    • Kalagher S.D.

    • et al.

  • Transjugular intrahepatic portal-systemic shunt in the treatment of refractory ascites: effect on clinical, renal, humoral, and hemodynamic parameters.

    Hepatology. 1995; 21: 986-994

    View in Article 

    • PubMed

    • Google Scholar

    • Quiroga J.

    • Sangro B.

    • Núñez M.

    • et al.

  • Changes in kidney function after transjugular intrahepatic portosystemic shunts versus large-volume paracentesis in cirrhosis: a matched cohort analysis.

    Am J Kidney Dis. 2016; 68: 381-391

    View in Article 

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Allegretti A.S.

    • Ortiz G.

    • Cui J.

    • et al.

  • Transjugular intrahepatic portosystemic stent-shunt for hepatorenal syndrome.

    Lancet. 1997; 349: 697-698

    View in Article 

    • Scopus (91)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Brensing K.A.

    • Textor J.

    • Strunk H.

    • et al.

  • Prognostic factors in patients with refractory ascites treated by transjugular intrahepatic porto-systemic shunt: from the liver to the kidney.

    Dig Liver Dis. 2014; 46: 1001-1007

    View in Article 

    • Scopus (5)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Hamel B.

    • Guillaud O.

    • Roman S.

    • et al.

  • Review article: renal function assessment in cirrhosis - difficulties and alternative measurements.

    Aliment Pharmacol Ther. 2007; 26: 969-978

    View in Article 

    • Scopus (115)

    • PubMed

    • Crossref

    • Google Scholar

    • Cholongitas E.

    • Shusang V.

    • Marelli L.

    • et al.

  • A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts.

    Hepatology. 2000; 31: 864-871

    View in Article 

    • PubMed

    • Crossref

    • Google Scholar

    • Malinchoc M.

    • Kamath P.S.

    • Gordon F.D.

    • et al.

  • Albumin-bilirubin and platelet-albumin-bilirubin grades do not predict survival after transjugular intrahepatic portosystemic shunt creation.

    Cardiovasc Intervent Radiol. 2018; 41: 1029-1034

    View in Article 

    • Scopus (10)

    • PubMed

    • Crossref

    • Google Scholar

    • Khabbaz R.C.

    • Lokken R.P.

    • Chen Y.F.

    • et al.

  • Incidence, natural history, and risk factors of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt with polytetrafluoroethylene-covered stent grafts.

    Am J Gastroenterol. 2008; 103: 2738-2746

    View in Article 

    • Scopus (174)

    • PubMed

    • Crossref

    • Google Scholar

    • Riggio O.

    • Angeloni S.

    • Salvatori F.M.

    • et al.

  • Randomized comparative study of therapeutic paracentesis with and without intravenous albumin in cirrhosis.

    Gastroenterology. 1988; 94: 1493-1502

    View in Article 

    • Scopus (509)

    • PubMed

    • Crossref

    • Google Scholar

    • Gines P.

    • Tito L.

    • Arroyo V.

    • et al.

  • Randomized trial comparing albumin and saline in the prevention of paracentesis-induced circulatory dysfunction in cirrhotic patients with ascites.

    Hepatology. 2003; 37: 1147-1153

    View in Article 

    • Scopus (169)

    • PubMed

    • Crossref

    • Google Scholar

    • Sola-Vera J.

    • Minana J.

    • Ricart E.

    • et al.

  • Time course of circulatory and humoral effects of rapid total paracentesis in cirrhotic patients with tense, refractory ascites.

    Gastroenterology. 1994; 106: 709-719

    View in Article 

    • Scopus (102)

    • PubMed

    • Abstract

    • Full Text PDF

    • Google Scholar

    • Pozzi M.

    • Osculati G.

    • Boari G.

    • et al.

  • Quality improvement goals for acute kidney injury.

    Clin J Am Soc Nephrol. 2019; 14: 941-953

    View in Article 

    • Scopus (66)

    • PubMed

    • Crossref

    • Google Scholar

    • Kashani K.

    • Rosner M.H.

    • Haase M.

    • et al.

  • Hepatorenal syndrome: resolution after transjugular intrahepatic portosystemic shunt.

    J Clin Gastroenterol. 1995; 20: 241-243

    View in Article 

    • PubMed

    • Crossref

    • Google Scholar

    • Sturgis T.M.

  • Improved clinical outcome using polytetrafluoroethylene-coated stents for TIPS: results of a randomized study.

    Gastroenterology. 2004; 126: 469-475

    View in Article 

    • Scopus (404)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Bureau C.

    • Garcia-Pagan J.C.

    • Otal P.

    • et al.

  • Hepatic encephalopathy after transjugular intrahepatic portosystemic shunt insertion: a decade of experience.

    QJM. 2008; 101: 493-501

    View in Article 

    • Scopus (54)

    • PubMed

    • Crossref

    • Google Scholar

    • Masson S.

    • Mardini H.A.

    • Rose J.D.

    • et al.

  • Patency and clinical outcomes of transjugular intrahepatic portosystemic shunt with polytetrafluoroethylene-covered stents versus bare stents: a meta-analysis.

    J Gastroenterol Hepatol. 2010; 25: 1718-1725

    View in Article 

    • Scopus (101)

    • PubMed

    • Crossref

    • Google Scholar

    • Yang Z.

    • Han G.

    • Wu Q.

    • et al.

  • Predictors of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in cirrhotic patients: a systematic review.

    J Gastroenterol Hepatol. 2011; 26: 943-951

    View in Article 

    • Scopus (105)

    • PubMed

    • Crossref

    • Google Scholar

    • Bai M.

    • Qi X.

    • Yang Z.

    • et al.

  • Clearing the confusion over hepatic encephalopathy after TIPS creation: incidence, prognostic factors, and clinical outcomes.

    Dig Dis Sci. 2015; 60: 1059-1066

    View in Article 

    • Scopus (52)

    • PubMed

    • Crossref

    • Google Scholar

    • Casadaban L.C.

    • Parvinian A.

    • Minocha J.

    • et al.

  • Sarcopenia is risk factor for development of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt placement.

    Clin Gastroenterol Hepatol. 2017; 15: 934-936

    View in Article 

    • Scopus (75)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Nardelli S.

    • Lattanzi B.

    • Torrisi S.

    • et al.

  • Sarcopenia is associated with development of acute-on-chronic liver failure in decompensated liver cirrhosis receiving transjugular intrahepatic portosystemic shunt.

    Clin Transl Gastroenterol. 2019; 10e00025

    View in Article 

    • Scopus (35)

    • PubMed

    • Crossref

    • Google Scholar

    • Praktiknjo M.

    • Clees C.

    • Pigliacelli A.

    • et al.

  • Important unresolved questions in the management of hepatic encephalopathy: an ISHEN consensus.

    Am J Gastroenterol. 2020; 115: 989-1002

    View in Article 

    • Scopus (13)

    • PubMed

    • Crossref

    • Google Scholar

    • Bajaj J.S.

    • Lauridsen M.

    • Tapper E.B.

    • et al.

  • Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by AASLD and EASL.

    Hepatology. 2014; 60: 715-735

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Vilstrup H.

    • Amodio P.

    • Bajaj J.

    • et al.

  • Pre-transjugular intrahepatic portosystemic shunts (TIPS) prediction of post-TIPS overt hepatic encephalopathy: the critical flicker frequency is more accurate than psychometric tests.

    Hepatology. 2014; 59: 622-629

    View in Article 

    • Scopus (46)

    • PubMed

    • Crossref

    • Google Scholar

    • Berlioux P.

    • Robic M.A.

    • Poirson H.

    • et al.

  • Cognitive impairment predicts the occurrence of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt.

    Am J Gastroenterol. 2016; 111: 523-528

    View in Article 

    • Scopus (28)

    • PubMed

    • Crossref

    • Google Scholar

    • Nardelli S.

    • Gioia S.

    • Pasquale C.

    • et al.

  • Detection of minimal hepatic encephalopathy: normalization and optimization of the Psychometric Hepatic Encephalopathy Score. A neuropsychological and quantified EEG study.

    J Hepatol. 2008; 49: 346-353

    View in Article 

    • Scopus (152)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Amodio P.

    • Campagna F.

    • Olianas S.

    • et al.

  • Impact of hepatic encephalopathy in cirrhosis on quality-of-life issues.

    Drugs. 2019; 79: 11-16

    View in Article 

    • Scopus (27)

    • PubMed

    • Crossref

    • Google Scholar

    • Montagnese S.

    • Bajaj J.S.

  • Covert hepatic encephalopathy is independently associated with poor survival and increased risk of hospitalization.

    Am J Gastroenterol. 2014; 109: 1757-1763

    View in Article 

    • Scopus (98)

    • PubMed

    • Crossref

    • Google Scholar

    • Patidar K.R.

    • Thacker L.R.

    • Wade J.B.

    • et al.

  • Clinical efficacy of transjugular intrahepatic portosystemic shunt created with expanded polytetrafluoroethylene-covered stent-grafts: 8-mm versus 10-mm.

    Cardiovasc Intervent Radiol. 2019; 42: 737-743

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Luo X.

    • Wang X.

    • Zhu Y.

    • et al.

  • Under-dilated TIPS associate with efficacy and reduced encephalopathy in a prospective, non-randomized study of patients with cirrhosis.

    Clin Gastroenterol Hepatol. 2018; 16: 1153-1162.e7

    View in Article 

    • Scopus (44)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Schepis F.

    • Vizzutti F.

    • Garcia-Tsao G.

    • et al.

  • Prevention of rebleeding from esophageal varices in patients with cirrhosis receiving small-diameter stents versus hemodynamically controlled medical therapy.

    Gastroenterology. 2015; 149: 660-668.e1

    View in Article 

    • Scopus (130)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Sauerbruch T.

    • Mengel M.

    • Dollinger M.

    • et al.

  • Total area of spontaneous portosystemic shunts independently predicts hepatic encephalopathy and mortality in liver cirrhosis.

    J Hepatol. 2020; 72: 1140-1150

    View in Article 

    • Scopus (38)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Praktiknjo M.

    • Simón-Talero M.

    • Römer J.

    • et al.

  • Association between portosystemic shunts and increased complications and mortality in patients with cirrhosis.

    Gastroenterology. 2018; 154: 1694-1705.e4

    View in Article 

    • Scopus (76)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Simón-Talero M.

    • Roccarina D.

    • Martínez J.

    • et al.

  • Association between non-variceal spontaneous portosystemic shunt and outcomes after TIPS in cirrhosis.

    Dig Liver Dis. 2018; 50: 1315-1323

    View in Article 

    • Scopus (11)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • He C.

    • Lv Y.

    • Wang Z.

    • et al.

  • Comparison of transjugular intrahepatic portosystemic shunt for treatment of variceal bleeding in patients with cirrhosis with or without spontaneous portosystemic shunt.

    Eur J Gastroenterol Hepatol. 2019; 31: 853-858

    View in Article 

    • Scopus (5)

    • PubMed

    • Crossref

    • Google Scholar

    • Leng X.

    • Zhang F.

    • Zhang M.

    • et al.

  • Pharmacological prophylaxis of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt: a randomized controlled study.

    J Hepatol. 2005; 42: 674-679

    View in Article 

    • Scopus (132)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Riggio O.

    • Masini A.

    • Efrati C.

    • et al.

  • Improvement in survival associated with embolisation of spontaneous portosystemic shunt in patients with recurrent hepatic encephalopathy.

    Aliment Pharmacol Ther. 2014; 39: 1418-1426

    View in Article 

    • Scopus (44)

    • PubMed

    • Crossref

    • Google Scholar

    • An J.

    • Kim K.W.

    • Han S.

    • et al.

  • Embolization of large spontaneous portosystemic shunts for refractory hepatic encephalopathy: a multicenter survey on safety and efficacy.

    Hepatology. 2013; 57: 2448-2457

    View in Article 

    • Scopus (144)

    • PubMed

    • Crossref

    • Google Scholar

    • Laleman W.

    • Simon-Talero M.

    • Maleux G.

    • et al.

  • Coil-Assisted Retrograde Transvenous Obliteration (CARTO): an alternative treatment option for refractory hepatic encephalopathy.

    Am J Gastroenterol. 2018; 113: 1187-1196

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Lee E.W.

    • Saab S.

    • Kaldas F.

    • et al.

  • Embolization of portosystemic shunts for treatment of medically refractory hepatic encephalopathy.

    Liver Transpl. 2016; 22: 723-731

    View in Article 

    • Scopus (31)

    • PubMed

    • Crossref

    • Google Scholar

    • Lynn A.M.

    • Singh S.

    • Congly S.E.

    • et al.

  • Percutaneous transvenous embolization for portosystemic shunts associated with encephalopathy: long-term outcomes in 14 patients.

    Hepatol Res. 2014; 44: 740-749

    View in Article 

    • Scopus (16)

    • PubMed

    • Crossref

    • Google Scholar

    • Naeshiro N.

    • Kakizawa H.

    • Aikata H.

    • et al.

  • Shunt occlusion for portosystemic shunt syndrome related refractory hepatic encephalopathy—a single-center experience in 21 patients from Kerala.

    Indian J Gastroenterol. 2017; 36: 411-419

    View in Article 

    • Scopus (0)

    • PubMed

    • Crossref

    • Google Scholar

    • Philips C.A.

    • Kumar L.

    • Augustine P.

  • The use of rifaximin in the prevention of overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt : a randomized controlled trial.

    Ann Intern Med. 2021; 174: 633-640

    View in Article 

    • Scopus (2)

    • PubMed

    • Crossref

    • Google Scholar

    • Bureau C.

    • Thabut D.

    • Jezequel C.

    • et al.

  • Hepatic encephalopathy after transjugular intrahepatic portosystemic shunt.

    Clin Liver Dis. 2012; 16: 133-146

    View in Article 

    • Scopus (86)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Riggio O.

    • Nardelli S.

    • Moscucci F.

    • et al.

  • Portosystemic pressure gradient during transjugular intrahepatic portosystemic shunt with Viatorr stent graft: what is the critical low threshold to avoid medically uncontrolled low pressure gradient related complications?.

    J Gastroenterol Hepatol. 2008; 23: 95-101

    View in Article 

    • Scopus (46)

    • PubMed

    • Crossref

    • Google Scholar

    • Chung H.H.

    • Razavi M.K.

    • Sze D.Y.

    • et al.

  • Management of transjugular intrahepatic portosystemic shunt (TIPS)-associated refractory hepatic encephalopathy by shunt reduction using the parallel technique: outcomes of a retrospective case series.

    Cardiovasc Intervent Radiol. 2011; 34: 92-99

    View in Article 

    • Scopus (15)

    • PubMed

    • Crossref

    • Google Scholar

    • Cookson D.T.

    • Zaman Z.

    • Gordon-Smith J.

    • et al.

  • Management of refractory hepatic encephalopathy after insertion of TIPS: long-term results of shunt reduction with hourglass-shaped balloon-expandable stent-graft.

    AJR Am J Roentgenol. 2009; 193: 1696-1702

    View in Article 

    • Scopus (53)

    • PubMed

    • Crossref

    • Google Scholar

    • Fanelli F.

    • Salvatori F.M.

    • Rabuffi P.

    • et al.

  • Transjugular intrahepatic portosystemic stent shunt (TIPSS) modification in the management of post-TIPSS refractory hepatic encephalopathy.

    Gut. 2006; 55: 1617-1623

    View in Article 

    • Scopus (43)

    • PubMed

    • Crossref

    • Google Scholar

    • Kochar N.

    • Tripathi D.

    • Ireland H.

    • et al.

  • Management of transjugular intrahepatic portosystemic shunt induced refractory hepatic encephalopathy with the parallel technique: results of a clinical follow-up study.

    J Vasc Interv Radiol. 2007; 18 (quiz 993): 986-992

    View in Article 

    • Scopus (27)

    • PubMed

    • Abstract

    • Full Text

    • Full Text PDF

    • Google Scholar

    • Maleux G.

    • Heye S.

    • Verslype C.

    • et al.

  • Endovascular shunt reduction in the management of transjugular portosystemic shunt-induced hepatic encephalopathy: preliminary experience with reduction stents and stent-grafts.

    AJR Am J Roentgenol. 2007; 188: 659-664

    View in Article 

    • Scopus (32)

    • PubMed

    • Crossref

    • Google Scholar

    • Maleux G.

    • Verslype C.

    • Heye S.

    • et al.

  • Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients.

    Hepatology. 1992; 16: 1343-1349

    View in Article 

    • Scopus (796)

    • PubMed

    • Crossref

    • Google Scholar

    • Sarin S.K.

    • Lahoti D.

    • Saxena S.P.

    • Murthy N.S.

    • Makwana U.K.

END

更多精彩内容
欢迎关注微信视频号

参考文献：略

相关阅读

戳一下，更有料！
中国介入医学的发展是否需要技师？
肠治久安，介入保平安
错过了根治时机，介入医学“胃”你而来
儿童血管瘤的九大治疗方法
肺癌不可怕，介入医学有妙招
【扫黄】介入医学治黄疸
肝癌大作战（2）载药微球
介入医学一出手，肠梗阻也要抖一抖
论介入医学科普的重要性
老烂腿的克星——介入治疗
腔静脉滤器的前世今生
隐形的生命线“输液港”
胡桃夹我“静脉路”，现代医学有介入
去医院看病，内科、外科还是介入？
划时代的医学革命-介人放射学
国家卫健委通知：大力扶持介入治疗，将介入治疗列为首要核心专科能力建设方向
咯血莫慌张，介入医学来帮忙
2021年“世界血栓日”
体检发现肝血管瘤怎么办？介入告诉你答案！
介入科疾病诊疗范围
“保髋”还是“置换”？先试试介入吧！
静脉曲张影响的美，介入帮您消除
打倒征兵体检拦路虎，介入圆你军人梦
三国有介入，周瑜是不是不会死？
史上最全股动脉介入穿刺止血器械和方法
太医联名上书，宫内必须设介入科，不然娘娘们可不答应！
介入十八般武艺致敬中国医师节！
年度最佳病例之《介入手术不仅能取血栓，还能取子弹》
介入栓塞治疗痔疮‖还你原装好"菊花"
介入这样对待胖子，可以？
子宫肌瘤莫烦恼，介入栓塞显神通
介入好消息‖六脉神剑治血糖
请收下这份血管图谱

医师节应该被记住的人-铅衣战士

星火介入漫画科普=介入医学是什么学科？什么叫介入治疗？

静脉血栓栓塞症（VTE）防治(一)

漫画科普||静脉血栓栓塞症（VTE）防治（二）下肢深静脉血栓篇

漫画科普||静脉血栓栓塞症（VTE）防治（三）肺栓篇

漫画科普||静脉血栓栓塞症VTE防治科普(四）

版权声明星火介入：专业介入医学平台

以上图片部分来源于网络

如有侵权请联系：xinghuojiru1

欢迎转发至朋友圈，让更多人了解介入知识，知道介入知识，让介入医学更好的造福百姓，为患者提供微创治疗，减小医源性创伤。

    本站是提供个人知识管理的网络存储空间，所有内容均由用户发布，不代表本站观点。请注意甄别内容中的联系方式、诱导购买等信息，谨防诈骗。如发现有害或侵权内容，请点击一键举报。
    转藏 分享 献花（0）

    来自： jiianwhy > 《TIPS》

    举报/认领

    0条评论

    发表

    请遵守用户 评论公约

    类似文章 更多