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Published on: May 7, 2015
A modified procedure for transjugular intrahepatic portosystemic shunt flow reduction
Alexis Jacquier1, Vincent Vidal, Olivier Monnet
1Department of Radiology Pr Bartoli-Pr Moulin, La Timone University Hospital, 264 rue St Pierre, 3385 Marseille 5, France. alexis.jacquier@ap-hm.fr
Journal of Vascular and Interventional Radiology : JVIR
|August 23, 2006
Summary
This study introduces a new transjugular intrahepatic portosystemic shunt (TIPS) procedure to effectively manage refractory hepatic encephalopathy. The modified technique demonstrated technical success and clinical improvement in all treated patients.
Area of Science:
- Interventional Cardiology
- Hepatology
- Vascular Surgery
Background:
- Refractory hepatic encephalopathy poses a significant clinical challenge.
- Transjugular intrahepatic portosystemic shunt (TIPS) procedures can sometimes lead to or worsen hepatic encephalopathy.
- Existing management strategies for TIPS-related hepatic encephalopathy have limitations.
Purpose of the Study:
- To present a modified transjugular intrahepatic portosystemic shunt (TIPS) flow reduction procedure.
- To evaluate the efficacy and safety of this modified TIPS procedure in treating TIPS-related refractory hepatic encephalopathy.
Main Methods:
- A modified TIPS flow reduction technique was employed.
- A 6-mm Uni Wallstent was deployed beyond the angulated portion of the TIPS.
- A Wallgraft was then coaxially deployed within the TIPS over the same guidewire.
Main Results:
- The procedure was technically and clinically successful in all six patients.
- No deaths occurred within the first month post-procedure.
- Three patients maintained TIPS patency for over 1 year.
Conclusions:
- The modified TIPS flow reduction procedure is a safe and effective treatment for refractory hepatic encephalopathy.
- This technique offers a viable solution for managing a challenging complication of TIPS procedures.
- The procedure demonstrates promising long-term patency and clinical outcomes.
