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V Vidal - One of the best experts on this subject based on the ideXlab platform.
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The presence of spontaneous Portosystemic Shunts increases the risk of ă complications after transjugular intrahepatic Portosystemic Shunt (TIPS) ă placement
Diagnostic and Interventional Imaging, 2016Co-Authors: Patrick Borentain, J. Soussan, N. Resseguier, D. Botta-fridlund, J.-c. Dufour, René Gerolami, V VidalAbstract:Purpose: The goal of this study was to identify clinical and imaging ă variables that are associated with an unfavorable outcome during the 30 ă days following transjugular intrahepatic Portosystemic Shunt (TIPS) ă placement. ă Material and methods: Fifty-four consecutive patients with liver ă cirrhosis (Child-Pugh 6-13, Model for End-stage Liver Disease 7-26) ă underwent TIPS placement for refractory ascites (n = 25), recurrent or ă uncontrolled variceal bleeding (n = 23) or both (n = 6). Clinical, ă biological and imaging variables including type of stent (covered n = ă 40; bare-stent n = 14), presence of spontaneous Portosystemic Shunt (n = ă 31), and variations in Portosystemic pressure gradient were recorded. ă Early severe complication was defined as the occurrence of overt hepatic ă encephalopathy or death within the 30 days following TIPS placement. ă Results: Sixteen patients (30%) presented with early severe ă complication after TIPS placement. Child-Pugh score was independently ă associated with complication (HR = 1.52, P < 0.001). Among the imaging ă variables, opacification of spontaneous Portosystemic Shunt during TIPS ă placement but before its creation was associated with an increased risk ă of early complication (P = 0.04). The other imaging variables were not ă associated with occurrence of complication. ă Conclusion: Identification of spontaneous Portosystemic Shunt during ă TIPS placement reflects the presence of varices and is associated with ă an increased risk of early severe complication.
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usefulness of transjugular intrahepatic Portosystemic Shunt in the management of bleeding ectopic varices in cirrhotic patients
CardioVascular and Interventional Radiology, 2006Co-Authors: V Vidal, L Joly, P Perreault, Louis Bouchard, M Lafortune, G PomierlayrarguesAbstract:Purpose To evaluate the safety and efficacy of transjugular intrahepatic Portosystemic Shunt (TIPS) in the control of bleeding from ectopic varices.
Patrick Borentain - One of the best experts on this subject based on the ideXlab platform.
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The presence of spontaneous Portosystemic Shunts increases the risk of ă complications after transjugular intrahepatic Portosystemic Shunt (TIPS) ă placement
Diagnostic and Interventional Imaging, 2016Co-Authors: Patrick Borentain, J. Soussan, N. Resseguier, D. Botta-fridlund, J.-c. Dufour, René Gerolami, V VidalAbstract:Purpose: The goal of this study was to identify clinical and imaging ă variables that are associated with an unfavorable outcome during the 30 ă days following transjugular intrahepatic Portosystemic Shunt (TIPS) ă placement. ă Material and methods: Fifty-four consecutive patients with liver ă cirrhosis (Child-Pugh 6-13, Model for End-stage Liver Disease 7-26) ă underwent TIPS placement for refractory ascites (n = 25), recurrent or ă uncontrolled variceal bleeding (n = 23) or both (n = 6). Clinical, ă biological and imaging variables including type of stent (covered n = ă 40; bare-stent n = 14), presence of spontaneous Portosystemic Shunt (n = ă 31), and variations in Portosystemic pressure gradient were recorded. ă Early severe complication was defined as the occurrence of overt hepatic ă encephalopathy or death within the 30 days following TIPS placement. ă Results: Sixteen patients (30%) presented with early severe ă complication after TIPS placement. Child-Pugh score was independently ă associated with complication (HR = 1.52, P < 0.001). Among the imaging ă variables, opacification of spontaneous Portosystemic Shunt during TIPS ă placement but before its creation was associated with an increased risk ă of early complication (P = 0.04). The other imaging variables were not ă associated with occurrence of complication. ă Conclusion: Identification of spontaneous Portosystemic Shunt during ă TIPS placement reflects the presence of varices and is associated with ă an increased risk of early severe complication.
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The presence of spontaneous Portosystemic Shunts increases the risk of complications after transjugular intrahepatic Portosystemic Shunt (TIPS) placement.
Diagnostic and interventional imaging, 2016Co-Authors: Patrick Borentain, J. Soussan, N. Resseguier, D. Botta-fridlund, J.-c. Dufour, René Gerolami, Vincent VidalAbstract:Abstract Purpose The goal of this study was to identify clinical and imaging variables that are associated with an unfavorable outcome during the 30 days following transjugular intrahepatic Portosystemic Shunt (TIPS) placement. Material and methods Fifty-four consecutive patients with liver cirrhosis (Child-Pugh 6–13, Model for End-stage Liver Disease 7–26) underwent TIPS placement for refractory ascites ( n = 25), recurrent or uncontrolled variceal bleeding ( n = 23) or both ( n = 6). Clinical, biological and imaging variables including type of stent (covered n = 40; bare-stent n = 14), presence of spontaneous Portosystemic Shunt ( n = 31), and variations in Portosystemic pressure gradient were recorded. Early severe complication was defined as the occurrence of overt hepatic encephalopathy or death within the 30 days following TIPS placement. Results Sixteen patients (30%) presented with early severe complication after TIPS placement. Child-Pugh score was independently associated with complication (HR = 1.52, P P = 0.04). The other imaging variables were not associated with occurrence of complication. Conclusion Identification of spontaneous Portosystemic Shunt during TIPS placement reflects the presence of varices and is associated with an increased risk of early severe complication.
Jaime Bosch - One of the best experts on this subject based on the ideXlab platform.
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systematic review with meta analysis portal vein recanalisation and transjugular intrahepatic Portosystemic Shunt for portal vein thrombosis
Alimentary Pharmacology & Therapeutics, 2019Co-Authors: S Rodrigues, Sebastian Sixt, Juan G Abraldes, Andrea De Gottardi, Christoph Klinger, Jaime Bosch, Iris Baumgartner, Annalisa BerzigottiAbstract:BACKGROUND Transjugular intrahepatic Portosystemic Shunt has been increasingly used in patients with portal vein thrombosis to obtain patency, but evidenced-based decisions are challenging. AIM To evaluate published data on efficacy and safety of endovascular therapy in portal vein thrombosis. METHODS Systematic search of PubMed, ISI, Scopus, and Embase for studies (in English, until October 2017) reporting feasibility, safety, 12-month portal vein recanalisation, transjugular intrahepatic Portosystemic Shunt patency, and survival in patients with benign portal vein thrombosis undergoing endovascular treatment. An independent extraction of articles using predefined data fields and quality indicators was used; pooled analyses based on random-effects models; heterogeneity assessment by Cochran's Q, I statistic, subgroup analyses, and meta-regression. RESULTS Thirteen studies including 399 patients (92% cirrhosis; portal vein thrombosis: complete 46%, chronic 87%, cavernous transformation 17%, superior mesenteric vein involvement 55%) were included. Transjugular intrahepatic Portosystemic Shunt was technically feasible in 95% (95% CI: 89%-98%) with heterogeneity (I = 57%, P < 0.001) explained by cavernous transformation. Major complications occurred in 10% (95% CI: 6.0%-18.0%; I = 52%, P = 0.55). Additional catheter-directed thrombolysis was associated with more complications compared to transjugular intrahepatic Portosystemic Shunt alone or plus thrombectomy (17.6% vs 3.3%). Twelve-month portal vein recanalisation was 79% (95% CI: 67%-88%; I = 78%, P < 0.01). Shunt patency at 12 months was 84% (95% CI: 76%-90%; I = 62%, P < 0.01). Overall 12-month survival rate was 89%, with no heterogeneity. CONCLUSIONS Transjugular intrahepatic Portosystemic Shunt for portal vein thrombosis recanalisation was highly feasible, effective, and safe. Cavernous transformation was the main determinant of technical failure. Additional catheter-directed thrombolysis was associated with higher risk of severe complications.
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Impact of prior Portosystemic Shunt procedures on outcome of liver transplantation.
Surgery, 2005Co-Authors: Alessandra Dell'era, Jaime Bosch, Luis Grande, Pablo Barros-schelotto, Juan Turnes, Josep Fuster, Ramón Charco, Juan-carlos Garcia-valdecasas, Juan Carlos García-pagánAbstract:Background Cirrhotic patients may require Portosystemic Shunts as treatment for complications of portal hypertension. The aim of this study was to asses how these procedures may influence the orthotopic liver transplantation procedure and its outcome. Methods Forty-five patients with a previous Portosystemic Shunt were divided into 3 groups (group 1, 19 with a portocaval Shunt; group 2, 4 with a mesocaval Shunt and 5 with a distal splenorenal Shunts; group 3, 17 with a transjugular intrahepatic Portosystemic Shunt). Forty-five patients without a Shunt, matched for age, gender, pretransplant liver status, and year of transplantation, were selected as controls. Surgical time, transfusional requirement, intensive care unit and total hospital duration of stay, complications, retransplantation rate, and short- and long-term mortality were analyzed. Results Group 1 showed a significantly longer surgical time, higher red blood cell transfusional requirements, longer intensive care unit and hospital stay, and greater short and long-term mortality than the controls. No significant differences were observed between groups 2 and 3 and the controls. Conclusions In cirrhotic patients, surgically created Portosystemic Shunts involving the hepatic hilum have a negative impact on liver transplantation. This operation should be avoided in potential liver transplant candidates; surgical Shunts that do not compromise the hepatic hilum or transjugular intrahepatic Portosystemic Shunts are preferred.
Jeffrey A Leef - One of the best experts on this subject based on the ideXlab platform.
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transjugular intrahepatic Portosystemic Shunt placement in patients with cirrhosis and concomitant portal vein thrombosis
CardioVascular and Interventional Radiology, 2006Co-Authors: Thuong G Van Ha, Justin Hodge, Brian Funaki, Jonathan M Lorenz, Jordan D Rosenblum, Christopher M Straus, Jeffrey A LeefAbstract:Purpose To determine the safety and efficacy of transjugular intrahepatic Portosystemic Shunt (TIPS) creation in patients with liver cirrhosis complicated by thrombosed portal vein.
Vincent Vidal - One of the best experts on this subject based on the ideXlab platform.
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The presence of spontaneous Portosystemic Shunts increases the risk of complications after transjugular intrahepatic Portosystemic Shunt (TIPS) placement.
Diagnostic and interventional imaging, 2016Co-Authors: Patrick Borentain, J. Soussan, N. Resseguier, D. Botta-fridlund, J.-c. Dufour, René Gerolami, Vincent VidalAbstract:Abstract Purpose The goal of this study was to identify clinical and imaging variables that are associated with an unfavorable outcome during the 30 days following transjugular intrahepatic Portosystemic Shunt (TIPS) placement. Material and methods Fifty-four consecutive patients with liver cirrhosis (Child-Pugh 6–13, Model for End-stage Liver Disease 7–26) underwent TIPS placement for refractory ascites ( n = 25), recurrent or uncontrolled variceal bleeding ( n = 23) or both ( n = 6). Clinical, biological and imaging variables including type of stent (covered n = 40; bare-stent n = 14), presence of spontaneous Portosystemic Shunt ( n = 31), and variations in Portosystemic pressure gradient were recorded. Early severe complication was defined as the occurrence of overt hepatic encephalopathy or death within the 30 days following TIPS placement. Results Sixteen patients (30%) presented with early severe complication after TIPS placement. Child-Pugh score was independently associated with complication (HR = 1.52, P P = 0.04). The other imaging variables were not associated with occurrence of complication. Conclusion Identification of spontaneous Portosystemic Shunt during TIPS placement reflects the presence of varices and is associated with an increased risk of early severe complication.
