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Consensus conference on TIPS management: Techniques, indications, contraindications.

Stefano Fagiuoli1, Raffaele Bruno2, Wilma Debernardi Venon3

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Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|November 26, 2016
PubMed
Summary
This summary is machine-generated.

Transjugular intrahepatic portosystemic shunt (TIPS) is now a primary treatment for portal hypertension, offering improved survival. Advances in covered stents enhance long-term device patency, expanding its clinical utility.

Keywords:
AscitesCirrhosisGI bleedingLiver transplantationPortal hypertensionTIPS

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Area of Science:

  • Interventional Radiology
  • Hepatology
  • Gastroenterology

Background:

  • Transjugular intrahepatic portosystemic shunt (TIPS) is evolving beyond salvage therapy for portal hypertension.
  • Self-expandable polytetrafluoroethylene (PTFE)-covered endoprostheses have significantly improved TIPS long-term patency.
  • New evidence since 2009 necessitates updated guidelines for TIPS indications and management.

Purpose of the Study:

  • To update international guidelines on transjugular intrahepatic portosystemic shunt (TIPS) indications.
  • To address areas of uncertainty and incorporate new evidence into clinical practice.
  • To provide evidence-based recommendations for the use of TIPS in managing portal hypertension.

Main Methods:

  • A consensus conference was convened by the Italian Association of the Study of the Liver (AISF), Italian College of Interventional Radiology-Italian Society of Medical Radiology (ICIR-SIRM), and Italian Society of Anesthesia, Analgesia, and Intensive Care (SIAARTI).
  • A scientific board of experts conducted a comprehensive literature review.
  • Consensus statements were formulated, graded by evidence quality and recommendation strength, and approved by an independent jury.

Main Results:

  • The consensus highlights the expanded role of TIPS in treating portal hypertension, improving survival.
  • Improved long-term patency of TIPS is attributed to advancements in PTFE-covered endoprostheses.
  • New indications and clarifications on existing uncertainties were addressed, strengthening the evidence base.

Conclusions:

  • The updated recommendations from AISF-ICIR-SIRM-SIAARTI provide a framework for current TIPS indications.
  • These recommendations emphasize the strengths and weaknesses of various TIPS applications.
  • The consensus serves as a foundation for future research in transjugular intrahepatic portosystemic shunt procedures.