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Transjugular intrahepatic portosystemic stent shunt
R Jalan1, D N Redhead, P C Hayes
1Royal Infirmary of Edinburgh, United Kingdom.
The National Medical Journal of India
|January 1, 1995
Summary
Transjugular intrahepatic portosystemic stent shunt (TIPSS) offers a successful treatment for portal hypertension complications like variceal bleeding and ascites. Ongoing research aims to improve stent design to minimize complications such as shunt dysfunction.
Area of Science:
- Interventional Radiology
- Hepatology
- Vascular Surgery
Background:
- Transjugular intrahepatic portosystemic stent shunt (TIPSS) is a critical intervention for managing complications of portal hypertension.
- It involves creating a shunt between the hepatic and portal veins through the liver parenchyma.
Purpose of the Study:
- To review the indications, success rates, complications, and future research directions for TIPSS.
- To highlight the role of TIPSS in managing refractory ascites, variceal bleeding, and other portal hypertension sequelae.
Main Methods:
- The study reviews existing literature and clinical data on TIPSS procedures.
- Success rates, mortality, and complication rates are analyzed based on reported outcomes.
Main Results:
- TIPSS procedures have high technical success rates (85%-95%) with low mortality (1%-2%).
- Major indications include failed variceal sclerotherapy, refractory ascites, and hypersplenism.
- Common complications include shunt dysfunction (15%-60%), rebleeding (10%-20%), encephalopathy (10%-20%), and liver function deterioration (25%-35%).
Conclusions:
- TIPSS is an effective treatment for specific portal hypertension complications.
- Further research is needed to develop improved stent designs to reduce shunt dysfunction.