| Revue: | Annals of hepatology |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000406041 |
| ISSN: | 1665-2681 |
| Autores: | De Keyzer, Bart1 Nevens, Frederik2 Laenen, Annouschka3 Heye, Sam1 Laleman, Wim2 Verslype, Chris2 van der Merwe, Schalk2 Maleux, Geert1 |
| Instituciones: | 1University Hospitals Leuven, Department of Radiology, Leuven, Brabant. Bélgica 2University Hospitals Leuven, Department of Gastroenterology and Hepatology, Leuven, Brabant. Bélgica 3Catholic University of Leuven, Interuniversity Centre for Biostatistics and Statistical Bioinformatics, Leuven, Brabant. Bélgica |
| Año: | 2016 |
| Periodo: | Nov-Dic |
| Volumen: | 15 |
| Número: | 6 |
| Paginación: | 911-917 |
| País: | México |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Analítico, descriptivo |
| Resumen en inglés | The purpose of this study was to assess the technical and clinical outcomes of transjugular intrahepatic portosystemic shunt (TIPS) reduction for the management of TIPS-induced acute liver decompensation. Between August 2000 and November 2013, 347 patients underwent a TIPS procedure in the authors’ institution; 21/347 (6%) developed post-TIPS acute liver decompensation which was managed using a percutaneous shunt reduction technique. Patient demographics, laboratory tests before and after initial TIPS and TIPS reduction, procedural data and clinical follow-up data were analysed. Results. Results. Results. Twenty-one patients (mean age 63 years) who underwent an initial TIPS procedure for variceal bleeding (n = 7; 33%) or refractory ascites (n = 14; 67%) successfully underwent shunt reduction ten days (3-34 days) after the initial TIPS procedure. The portosystemic pressure gradient (PSPG) increased from 8 (3-17) mmHg before reduction to 12 (7-23) mmHg after shunt reduction. Survival at one and six months follow-up was 15 (71%) and 11 patients (52%), respectively. The international normalised ratio (INR) (1.7 vs. 1.5; p = 0.044) was significantly different after TIPS reduction in the non-survival group compared to the survival group. In conclusion, TIPS reduction for the management of TIPS-induced acute liver decompensation is technically feasible and is associated with a one and six-month mortality rate of 29% and 48%, respectively. Higher post-TIPS-reduction INR values may be associated with higher risk of early mortality |
| Disciplinas: | Medicina |
| Palabras clave: | Gastroenterología, Terapéutica y rehabilitación, Descompensación hepática aguda, Derivación portosistémica intrahepática transyugular, Radiología intervencionista |
| Keyword: | Medicine, Gastroenterology, Therapeutics and rehabilitation, Acute liver decompensation, Transjugular intrahepatic portosystemic shunt, Interventional radiology |
| Texte intégral: | Texto completo (Ver PDF) |
