The Experts below are selected from a list of 114 Experts worldwide ranked by ideXlab platform

Ron C. Gaba - One of the best experts on this subject based on the ideXlab platform.

  • 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.
    Journal of vascular and interventional radiology : JVIR, 2016
    Co-Authors: Janesh Lakhoo, James T. Bui, R. Peter Lokken, Charles E. Ray, Ron C. Gaba
    Abstract:

    Abstract Purpose To assess the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) creation with or without variceal coil and/or plug embolization in decompressing or occluding Gastric varices (GVs). Materials and Methods In this retrospective study, 78 patients with GV bleeding who underwent TIPS creation with or without embolotherapy with metallic coils and/or plugs from 1999 to 2014 were identified. Individuals who had a bare-metal TIPS and/or lacked post-TIPS imaging or endoscopic follow-up were excluded. The final cohort included 26 patients (16 men; median age, 54 y; median Model for End-stage Liver Disease score, 16). Variceal types, supplying vessels, and postprocedure GV patency on cross-sectional imaging or endoscopy were assessed. The primary study outcome measure was GV patency rate as a surrogate for efficacy of TIPS creation with or without embolization. Results GVs included gastroesophageal varix types 1 (n = 10) and 2 (n = 2), isolated GV types 1 (n = 4) and 2 (n = 2), and unspecified (n = 8). TIPS creation resulted in a median final portosystemic pressure gradient of 7 mm Hg. Multiple GV-supplying vessels (left/posterior/Short Gastric Veins) were present in 65% of patients (n = 17). Embolization was performed in 69% (n = 18). Thirteen, four, and nine patients had imaging, endoscopic, or both imaging/endoscopic follow-up. GV patency rate was 65% (n = 17; 61%/75% with/without embolization) at a median of 128.5 days (range, 1–1,295 d) after TIPS creation. Incidence of recurrent bleeding was 27% (n = 7), and the 90-day mortality rate was 15% (n = 4). Conclusions In this study, most GVs showed persistent patency despite TIPS decompression and variceal embolization, and the incidence of recurrent bleeding was high. The findings suggest suboptimal efficacy for GVs, and indicate a need for study of alternative or adjunctive approaches to GV treatment, such as chemical obliteration.

Gordon K. Mclean - One of the best experts on this subject based on the ideXlab platform.

  • Stent placement in a splenic vein stenosis after TIPS creation.
    Radiology, 1993
    Co-Authors: Saruhan Cekirge, J P Weiss, R G Foster, Gordon K. Mclean
    Abstract:

    A hemodynamically significant splenic vein stenosis was found during placement of a transjugular intrahepatic portosystemic shunt in a patient with Gastric variceal bleeding. A second stent was placed across the splenic vein stenosis, which was obstructing normal hepatopetal flow, causing venous hypertension in the splenic and Short Gastric Veins. This produced a successful hemodynamic and angiographic result and, clinically, controlled the patient's bleeding.

Wen-sheng Tzeng - One of the best experts on this subject based on the ideXlab platform.

  • Isolated Gastric varices due to focal splenic vein stenosis.
    Journal of the Formosan Medical Association = Taiwan yi zhi, 2004
    Co-Authors: Hock-khiam Wong, Hsing-tao Kuo, Sun-lung Tsai, Yih-huei Uen, Wen-sheng Tzeng
    Abstract:

    Left-sided portal hypertension due to splenic vein stenosis is a very rare disease. We report a case of this condition in a 21-year-old woman who suffered from a first episode of tarry stool passage with fresh blood vomiting. Panendoscopy showed isolated Gastric varices while sonography showed a normal liver but the presence of splenomegaly with prominent collateral circulations. Further imaging studies, including abdominal computed tomography, splenoportography and percutaneous transhepatic portography, revealed a focal stenotic proximal splenic vein resulting in left-sided portal hypertension. The collateral circulation ran from the Short Gastric Veins via the left Gastric Veins into the main portal vein. The intraportal venous pressure was within normal limits. Splenectomy was performed and near normal wedge liver biopsy pathology confirmed non-cirrhotic extrahepatic portal hypertension. The patient had no further variceal bleeding after surgery.

Janesh Lakhoo - One of the best experts on this subject based on the ideXlab platform.

  • 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.
    Journal of vascular and interventional radiology : JVIR, 2016
    Co-Authors: Janesh Lakhoo, James T. Bui, R. Peter Lokken, Charles E. Ray, Ron C. Gaba
    Abstract:

    Abstract Purpose To assess the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) creation with or without variceal coil and/or plug embolization in decompressing or occluding Gastric varices (GVs). Materials and Methods In this retrospective study, 78 patients with GV bleeding who underwent TIPS creation with or without embolotherapy with metallic coils and/or plugs from 1999 to 2014 were identified. Individuals who had a bare-metal TIPS and/or lacked post-TIPS imaging or endoscopic follow-up were excluded. The final cohort included 26 patients (16 men; median age, 54 y; median Model for End-stage Liver Disease score, 16). Variceal types, supplying vessels, and postprocedure GV patency on cross-sectional imaging or endoscopy were assessed. The primary study outcome measure was GV patency rate as a surrogate for efficacy of TIPS creation with or without embolization. Results GVs included gastroesophageal varix types 1 (n = 10) and 2 (n = 2), isolated GV types 1 (n = 4) and 2 (n = 2), and unspecified (n = 8). TIPS creation resulted in a median final portosystemic pressure gradient of 7 mm Hg. Multiple GV-supplying vessels (left/posterior/Short Gastric Veins) were present in 65% of patients (n = 17). Embolization was performed in 69% (n = 18). Thirteen, four, and nine patients had imaging, endoscopic, or both imaging/endoscopic follow-up. GV patency rate was 65% (n = 17; 61%/75% with/without embolization) at a median of 128.5 days (range, 1–1,295 d) after TIPS creation. Incidence of recurrent bleeding was 27% (n = 7), and the 90-day mortality rate was 15% (n = 4). Conclusions In this study, most GVs showed persistent patency despite TIPS decompression and variceal embolization, and the incidence of recurrent bleeding was high. The findings suggest suboptimal efficacy for GVs, and indicate a need for study of alternative or adjunctive approaches to GV treatment, such as chemical obliteration.

Goro Kajiyama - One of the best experts on this subject based on the ideXlab platform.

  • Three-Dimensional Portography Using Multislice Helical CT Is Clinically Useful for Management of Gastric Fundic Varices
    AJR. American journal of roentgenology, 2001
    Co-Authors: Akiko Matsumoto, Mikiya Kitamoto, Michio Imamura, Toshio Nakanishi, Chiaki Ono, Katsuhide Ito, Goro Kajiyama
    Abstract:

    OBJECTIVE. This study seeks to evaluate three-dimensional (3D) helical CT portography as a tool for examining patients with Gastric fundic varices.SUBJECTS AND METHODS. We compared 3D helical CT portography and conventional angiographic portography in 30 consecutive patients with Gastric fundic varices. We assessed whether 3D helical CT portography is useful in selecting patients and in evaluating the results of balloon-occluded retrograde transvenous obliteration.RESULTS. Three-dimensional helical CT portography simultaneously depicted second or third branches of the intrahepatic portal vein and provided images of entire portosystemic collaterals. On 3D helical CT portography, Gastric fundic varices were seen in 30 patients (100%), left Gastric Veins in 19 (63%), posterior Gastric Veins or Short Gastric Veins in 28 (93%), gastrorenal shunts in 27 (90%), paraumbilical Veins in three (10%), and inferior phrenic Veins in two patients (7%). Findings of 3D helical CT portography and conventional angiographic ...