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[Portal hemodynamic changes from TIPS--evaluation with pulse Doppler method]

K Ogawa¹, Y Naritaka, T Shimakawa

¹Department of Surgery, Tokyo Women's Medical College Daini Hospital.

Nihon Shokakibyo Gakkai Zasshi = the Japanese Journal of Gastro-Enterology

|March 1, 1995

Summary

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Transjugular intrahepatic portosystemic shunt (TIPS) improved portal hemodynamics in Child C cirrhosis patients. This effective treatment reduced portal pressure, resolving esophageal varices and ascites.

Area of Science:

Hepatology
Interventional Radiology
Vascular Imaging

Background:

Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure used to treat portal hypertension.
Child C liver cirrhosis represents advanced liver disease with significant complications.

Observation:

Portal hemodynamics were assessed using pulse Doppler before and after TIPS in three Child C cirrhosis patients.
Pre-TIPS assessment revealed decreased portal blood flow velocity and volume, increased cross-sectional vein area, and a high congestion index, indicating significant portal venous congestion.
Post-TIPS assessment showed increased blood flow velocity and volume, reduced vein cross-sectional area, and a lower congestion index, signifying improved portal hemodynamics.

Findings:

TIPS application resulted in an average portal venous pressure reduction of 10.7 mmHg.

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Clinical improvements included the disappearance of esophageal varices and reduction in ascites.

Pulse Doppler imaging confirmed significant improvements in portal hemodynamics, including increased flow velocity and volume, and decreased congestion.

Implications:

TIPS is clinically effective in managing advanced liver cirrhosis complications.
Pulse Doppler is a valuable, non-invasive tool for monitoring TIPS stent patency and assessing portal hemodynamics post-procedure.
These findings support the use of TIPS as a therapeutic option for severe portal hypertension in liver cirrhosis.