Urgent transjugular intrahepatic portosystemic shunt for control of acute variceal bleeding

The American Journal of Gastroenterology
R BañaresE Cos

Abstract

Endoscopic sclerotherapy and pharmacological therapy are widely used in the treatment of acute variceal hemorrhage. However, they fail at arresting acute bleeding in 20-30% of bleeding episodes. The efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in the prevention of recurrent variceal bleeding has been proved recently, but the effectiveness and safety of urgent TIPS in the treatment of acute variceal bleeding refractory to conventional therapy are still under evaluation. Over 4.5 yr, 358 variceal hemorrhage episodes were treated in our hospital. Pharmacological and endoscopic therapy failed to control hemorrhage in 93 episodes. Thirty-two patients died because of uncontrolled massive bleeding. In 56 patients, TIPS (Strecker stent) was performed after temporary control of the episode with balloon tamponade. Eleven of 56 patients with urgent TIPS belonged to Child-Pugh class A, 22 to class B, and 23 to class C. The mean time between indication and insertion was 17 +/- 10 h (range 4-24 h). Control of bleeding was achieved in 53 patients (95 %). Eight patients had recurrent bleeding at 1 month after TIPS, seven of them during the first week after the procedure. The 1-month actuarial probability of rebleeding was 2...Continue Reading

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Citations

Dec 1, 2005·Seminars in Interventional Radiology·Jorge E Lopera
Jun 1, 2006·Seminars in Interventional Radiology·Renato RipamontiNilesh H Patel
Jun 25, 2010·The New England Journal of Medicine·Juan Carlos García-PagánUNKNOWN Early TIPS (Transjugular Intrahepatic Portosystemic Shunt) Cooperative Study Group
May 28, 2005·Digestive Diseases·Andreas Ochs
Oct 12, 2013·World Journal of Gastroenterology : WJG·Romaric LoffroyJean-Pierre Cercueil
Mar 3, 2017·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Elliot B TapperSameer Saini
May 24, 2000·The Journal of Trauma·D LudwigR V Maier
May 8, 2001·European Journal of Gastroenterology & Hepatology·T BizollonC Trepo
May 8, 2001·European Journal of Gastroenterology & Hepatology·P Vlavianos, D Westaby
Jan 15, 2000·Journal of Clinical Gastroenterology·J P OngZ M Younossi
Feb 23, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Yongjun ZhuLi Yang
Dec 19, 2012·Canadian Association of Radiologists Journal = Journal L'Association Canadienne Des Radiologistes·Jeffrey D JaskolkaTanya P Chawla
Dec 11, 2014·World Journal of Gastroenterology : WJG·Sith Siramolpiwat
May 7, 2019·Canadian Journal of Gastroenterology & Hepatology·Charlotte BouzbibMarika Rudler
Jul 17, 2020·JHEP Reports : Innovation in Hepatology·Juan Carlos García-PagánGuadalupe Garcia-Tsao
Sep 3, 2016·Current Problems in Surgery·Audrey E ErtelShimul A Shah
Apr 12, 2021·Clinics in Liver Disease·Anna BaigesJuan Carlos García-Pagán
Oct 31, 2019·Clinics and Research in Hepatology and Gastroenterology·Manon AllaireJean-Charles Nault
May 22, 2021·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Aurélie WalterUNKNOWN Salvage TIPS Group
Apr 1, 2009·Medical Image Analysis·Guillaume PiliereElizabeth Bullitt

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