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Transjugular Intrahepatic Portosystemic Shunt Creation in Children Weighing <10 kg Using an Unconventional Technique
Emilio Sanín1, Margarita Suárez-Galvis2, Sergio Álvarez1
1Department of Interventional Radiology, Hospital Pablo Tobón Uribe, Medellín, Colombia.
Insights
Transjugular intrahepatic portosystemic shunt (TIPS) creation is safe and effective for children under 10 kg with portal hypertension complications. This study shows 100% technical and clinical success in a small pediatric cohort.
Area of Science:
- Pediatric Interventional Radiology
- Hepatology
- Vascular Surgery
Background:
- Transjugular intrahepatic portosystemic shunt (TIPS) creation is a standard procedure for portal hypertension complications.
- TIPS is infrequently performed in small children (<10 kg) due to technical challenges and limited outcome data.
Purpose of the Study:
- To evaluate the safety and efficacy of TIPS creation in pediatric patients weighing less than 10 kg.
- To describe the specialized techniques and materials used in this pediatric cohort.
Main Methods:
- Retrospective analysis of 8 children weighing <10 kg who underwent TIPS creation.
- Description of unconventional techniques and materials utilized for the procedure.
Main Results:
- 100% technical success rate.
- 100% clinical success rate.
- Demonstrated safety and effectiveness in this small pediatric group.
Conclusions:
- TIPS creation is a viable and effective treatment for variceal bleeding and other complications of portal hypertension in very small children.
- The findings support the use of TIPS in pediatric patients weighing <10 kg, despite technical difficulties.
Abstract:
Transjugular intrahepatic portosystemic shunt (TIPS) creation is a standard therapeutic procedure for the management of complications of portal hypertension. However, in small children, this procedure is infrequently performed because of technical difficulties owing to their small size and scarce information on outcomes. This article presents the results of treatment of variceal bleeding with TIPS creation in 8 children weighing <10 kg, along with the description of the unconventional techniques and materials required. Technical and clinical success rates were 100%. Although this was a small cohort of patients, the results obtained suggest that this is a safe and technically and clinically effective treatment option for complications of portal hypertension in this age group.
