期刊
JOURNAL OF HEPATOLOGY
卷 74, 期 1, 页码 230-234出版社
ELSEVIER
DOI: 10.1016/j.jhep.2020.09.018
关键词
Cirrhosis; Portal hypertension; Ascites; Variceal bleeding; Hepatic encephalopathy; Rifaximin; Propranolol; Embolisation of portosystemic collaterals; Splenic artery embolisation
资金
- Stiftung fur Leberkrankheiten, Bern
- Instituto de Salud Carlos III, Ministry of Health, Spain
TIPS is increasingly used worldwide to treat complications of portal hypertension in patients with advanced cirrhosis, but its use is hampered by the risk of causing hepatic encephalopathy and worsening liver function. Reported hemodynamic targets for TIPS may need to be adjusted in the pre-covered stent era to overcome limitations and maintain the beneficial effects of the procedure.
Transjugular intrahepatic portosystemic shunt (TIPS) is increasingly used worldwide to treat the complications of portal hypertension in patients with advanced cirrhosis. However, its use is hampered by the risk of causing hepatic encephalopathy and of worsening liver function. The reported haemodynamic targets used to guide TIPS are too narrow to be achieved in most cases and are perhaps not entirely adequate nowadays as they were obtained in the pre-covered stent era. We propose that small diameter TIPS - alone or combined to pharmacological therapy or ancillary interventional radiology procedures - may overcome these limitations while maintaining the beneficial effects of the procedure. (c) 2020 European Association for the Study of the Liver. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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