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Technical advances in transjugular intrahepatic portosystemic shunts.
Zemel G, Becker GJ, Bancroft JW, Benenati JF, Katzen BT.
Department of Radiology, Miami Vascular Institute, Baptist Hospital of Miami, FL 33176.
Radiographics. 1992 Jul;12(4):615-22; discussion 623-4
A transjugular intrahepatic portosystemic shunt (TIPS) can be created percutaneously with the Palmaz balloon-expandable stent. This article describes a transjugular-only approach with a 16-gauge needle. A functional and efficacious shunt can be achieved in most cases with stent diameters of 8-10 mm. Occasionally, a 12-mm-diameter shunt is necessary for effective variceal decompression. The procedure is considered successful when the portosystemic gradient is lowered to 12 mm Hg or less after stent placement. Hepatic vein stenosis in the shunt outflow can develop after the TIPs procedure. This complication has been treated successfully with additional stent placement. TIPS can undoubtedly be performed successfully and safely with a transjugular-only approach; however, the full impact of TIPS on the treatment of portal hypertension remains to be determined.
Posted via PubMed for educational and discussion purposes only.
Link to PubMed Reference
Department of Radiology, Miami Vascular Institute, Baptist Hospital of Miami, FL 33176.
Radiographics. 1992 Jul;12(4):615-22; discussion 623-4
A transjugular intrahepatic portosystemic shunt (TIPS) can be created percutaneously with the Palmaz balloon-expandable stent. This article describes a transjugular-only approach with a 16-gauge needle. A functional and efficacious shunt can be achieved in most cases with stent diameters of 8-10 mm. Occasionally, a 12-mm-diameter shunt is necessary for effective variceal decompression. The procedure is considered successful when the portosystemic gradient is lowered to 12 mm Hg or less after stent placement. Hepatic vein stenosis in the shunt outflow can develop after the TIPs procedure. This complication has been treated successfully with additional stent placement. TIPS can undoubtedly be performed successfully and safely with a transjugular-only approach; however, the full impact of TIPS on the treatment of portal hypertension remains to be determined.
Posted via PubMed for educational and discussion purposes only.
Link to PubMed Reference
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