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Robert L Vogelzang - One of the best experts on this subject based on the ideXlab platform.

  • us guided paraumbilical Vein puncture an adjunct to transjugular intrahepatic portosystemic shunt tips placement
    Journal of Vascular and Interventional Radiology, 1992
    Co-Authors: Frederik Wenz, Albert A Nemcek, Howard A Tischler, Paul L Minor, Robert L Vogelzang
    Abstract:

    Transjugular intrahepatic portosystemic stent-shunt placement has shown great promise as a means of portal decompression in patients with severe portal hypertension. Passage of a needle from the hepatic venous system into the portal venous system during this procedure may be technically difficult; while it would be advantageous to precisely target the portal Vein, most methods of localization are themselves technically difficult, risky, or time-consuming. The authors describe a method of localization of the portal Vein that, when feasible, appears to be both safe and technically simple. This method involves percutaneous catheterization of a paraumbilical portosystemic Collateral Vein under sonographic guidance.

Daiming Fan - One of the best experts on this subject based on the ideXlab platform.

  • transjugular intrahepatic portosystemic shunt for portal cavernoma with symptomatic portal hypertension in non cirrhotic patients
    Digestive Diseases and Sciences, 2012
    Co-Authors: Guohong Han, Zhanxin Yin, Jianhong Wang, Wengang Guo, Jing Niu, Wei Zhang, Ming Bai, Daiming Fan
    Abstract:

    Background Portal cavernoma is regarded as a contraindication to transjugular intrahepatic portosystemic shunt (TIPS). Aim To evaluate the feasibility, safety, and efficacy of TIPS for symptomatic portal hypertension in non-cirrhotic patients with portal cavernoma. Methods Between July 2002 and December 2009, 46 consecutive non-cirrhotic patients with portal cavernoma were admitted to our center. Twenty patients presented with variceal rebleeding (n = 20) and refractory ascites (n = 1), and were treated with TIPS. They were followed until either death or July 2010. Data were compared using the Fisher’s exact test or t test. Results TIPS were successfully placed in 35% (7/20) of patients via a transjugular approach alone (n = 1), a combined transjugular/transhepatic approach (n = 4), and a combined transjugular/transsplenic approach (n = 2). TIPS were inserted in a large Collateral Vein in two patients in whom recanalization of the occluded main portal Vein was impossible. Procedure-related complication was hepatic capsule perforation in one patient who was cured by medical therapy alone. Shunt dysfunction occurred in two patients, but TIPS revision was failed in one of them. Portosystemic pressure gradient was significantly reduced in TIPS success group (26.3 ± 1.1 vs. 12.4 ± 1.1 mmHg, p \ 0.001). The incidence of variceal bleeding in TIPS success group is lower than that in TIPS failure group (14 vs. 69%, p = 0.057). In TIPS success group, two patients died of systemic infection and accident, respectively. In TIPS failure group, two patients died of liver failure. Conclusions TIPS procedures are feasible and safe in selected patients with portal cavernoma. Successful TIPS insertions may decrease the incidence of variceal rebleeding.

Frederik Wenz - One of the best experts on this subject based on the ideXlab platform.

  • us guided paraumbilical Vein puncture an adjunct to transjugular intrahepatic portosystemic shunt tips placement
    Journal of Vascular and Interventional Radiology, 1992
    Co-Authors: Frederik Wenz, Albert A Nemcek, Howard A Tischler, Paul L Minor, Robert L Vogelzang
    Abstract:

    Transjugular intrahepatic portosystemic stent-shunt placement has shown great promise as a means of portal decompression in patients with severe portal hypertension. Passage of a needle from the hepatic venous system into the portal venous system during this procedure may be technically difficult; while it would be advantageous to precisely target the portal Vein, most methods of localization are themselves technically difficult, risky, or time-consuming. The authors describe a method of localization of the portal Vein that, when feasible, appears to be both safe and technically simple. This method involves percutaneous catheterization of a paraumbilical portosystemic Collateral Vein under sonographic guidance.

Guohong Han - One of the best experts on this subject based on the ideXlab platform.

  • transjugular intrahepatic portosystemic shunt for portal cavernoma with symptomatic portal hypertension in non cirrhotic patients
    Digestive Diseases and Sciences, 2012
    Co-Authors: Guohong Han, Zhanxin Yin, Jianhong Wang, Wengang Guo, Jing Niu, Wei Zhang, Ming Bai, Daiming Fan
    Abstract:

    Background Portal cavernoma is regarded as a contraindication to transjugular intrahepatic portosystemic shunt (TIPS). Aim To evaluate the feasibility, safety, and efficacy of TIPS for symptomatic portal hypertension in non-cirrhotic patients with portal cavernoma. Methods Between July 2002 and December 2009, 46 consecutive non-cirrhotic patients with portal cavernoma were admitted to our center. Twenty patients presented with variceal rebleeding (n = 20) and refractory ascites (n = 1), and were treated with TIPS. They were followed until either death or July 2010. Data were compared using the Fisher’s exact test or t test. Results TIPS were successfully placed in 35% (7/20) of patients via a transjugular approach alone (n = 1), a combined transjugular/transhepatic approach (n = 4), and a combined transjugular/transsplenic approach (n = 2). TIPS were inserted in a large Collateral Vein in two patients in whom recanalization of the occluded main portal Vein was impossible. Procedure-related complication was hepatic capsule perforation in one patient who was cured by medical therapy alone. Shunt dysfunction occurred in two patients, but TIPS revision was failed in one of them. Portosystemic pressure gradient was significantly reduced in TIPS success group (26.3 ± 1.1 vs. 12.4 ± 1.1 mmHg, p \ 0.001). The incidence of variceal bleeding in TIPS success group is lower than that in TIPS failure group (14 vs. 69%, p = 0.057). In TIPS success group, two patients died of systemic infection and accident, respectively. In TIPS failure group, two patients died of liver failure. Conclusions TIPS procedures are feasible and safe in selected patients with portal cavernoma. Successful TIPS insertions may decrease the incidence of variceal rebleeding.

David C Linehan - One of the best experts on this subject based on the ideXlab platform.