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01.01.2020 | IM - REVIEW

Transjugular intrahepatic portosystemic shunt (TIPS): current indications and strategies to improve the outcomes

verfasst von: Francesco Vizzutti, Filippo Schepis, Umberto Arena, Fabrizio Fanelli, Stefano Gitto, Silvia Aspite, Laura Turco, Gabriele Dragoni, Giacomo Laffi, Fabio Marra

Erschienen in: Internal and Emergency Medicine | Ausgabe 1/2020

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Abstract

Transjugular intrahepatic portosystemic shunt (TIPS) represents a very effective treatment of complications of portal hypertension. Established indications to TIPS in cirrhotic patients include portal hypertensive bleeding and refractory ascites. Over the years additional indications have been proposed, such as the treatment of vascular disease of the liver, hepatic hydrothorax, hepatorenal syndrome and bleeding from ectopic varices. Indications under evaluation include treatment of portal hypertension prior to major abdominal surgery and treatment of portal vein thrombosis. In spite of these advances, there are still uncertainties regarding the appropriate workup for patients to be scheduled for TIPS. Moreover, prevention and management of post-TIPS complications including hepatic encephalopathy and heart failure are still suboptimal. These issues are particularly relevant considering aging in TIPS candidates in Western countries. Correct selection of patients is mandatory to prevent complications which may eventually frustrate the good hemodynamic results and worsen the patient’s quality of life or even life expectancy. The possible role of small diameter TIPS to prevent post-procedural complications is discussed.

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Titel: Transjugular intrahepatic portosystemic shunt (TIPS): current indications and strategies to improve the outcomes
verfasst von: Francesco Vizzutti
Filippo Schepis
Umberto Arena
Fabrizio Fanelli
Stefano Gitto
Silvia Aspite
Laura Turco
Gabriele Dragoni
Giacomo Laffi
Fabio Marra
Publikationsdatum: 01.01.2020
Verlag: Springer International Publishing
Erschienen in: Internal and Emergency Medicine / Ausgabe 1/2020
Print ISSN: 1828-0447
Elektronische ISSN: 1970-9366
DOI: https://doi.org/10.1007/s11739-019-02252-8

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