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Cardiovasc Intervent Radiol. 2006 Sep-Oct;29(5):785-90.

Transjugular intrahepatic portosystemic shunt placement in patients with cirrhosis and concomitant portal vein thrombosis.

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1
Department of Radiology, Section of Interventional Radiology, The University of Chicago, 5841 South Maryland Avenue MC 2026, Chicago, IL 60637, USA. tgvanha@radiology.bsd.uchicago.edu

Abstract

PURPOSE:

To determine the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) creation in patients with liver cirrhosis complicated by thrombosed portal vein.

METHODS:

This study reviewed 15 cases of TIPS creation in 15 cirrhotic patients with portal vein thrombosis at our institution over an 8-year period. There were 2 women and 13 men with a mean age of 53 years. Indications were refractory ascites, variceal hemorrhage, and refractory pleural effusion. Clinical follow-up was performed in all patients.

RESULTS:

The technical success rate was 75% (3/4) in patients with chronic portal vein thrombosis associated with cavernomatous transformation and 91% (10/11) in patients with acute thrombosis or partial thrombosis, giving an overall success rate of 87%. Complications included postprocedural encephalopathy and localized hematoma at the access site. In patients with successful shunt placement, the total follow-up time was 223 months. The 30-day mortality rate was 13%. Two patients underwent liver transplantation at 35 days and 7 months, respectively, after TIPS insertion. One patient had an occluded shunt at 4 months with an unsuccessful revision. The remaining patients had functioning shunts at follow-up.

CONCLUSION:

TIPS creation in thrombosed portal vein is possible and might be a treatment option in certain patients.

PMID:
16850140
DOI:
10.1007/s00270-005-0090-4
[Indexed for MEDLINE]
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