ArticleThe British journal of radiology2018
Primary constrained TIPS for treating refractory ascites or variceal bleeding secondary to hepatic cirrhosis.
Article in The British journal of radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Expandable Constrained Transjugular Intrahepatic Portosystemic Shunt: An Individualised Approach for High-Risk Patients?Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- Effect of transjugular intrahepatic portosystemic shunt on platelet count and exact spleen volume segmented on computed tomography.Acta radiologica open · 2025Article
- IR management of portal hypertension complications.Clinical liver disease · 2023Article
- Transjugular Intrahepatic Portosystemic Shunt Placement: Entering the Era of Controlled Expansion.Cardiovascular and interventional radiology · 2023Article
- Article
- How Controlled is the Expansion of VIATORR CX?Cardiovascular and interventional radiology · 2023Article
- Hepatic Venous Pressure Gradient.Clinical liver disease · 2021Review
- Current Management of Intestinal Stomas and Their Complications.Journal of the anus, rectum and colon · 2020Review
- Laparoscopic totally extraperitoneal (TEP) inguinal hernia repair in patients with liver cirrhosis accompanied by ascites.Medicine · 2019Article
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Authors and funding
7 authors.
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Abstract
objectiveTo report an initial experience using a primary constrained transjugular intrahepatic portosystemic shunt (TIPS) technique for treating cirrhotic patients with refractory ascites or variceal bleeding.
methodsAll patients undergoing primary constrained (n = 9) and conventional (n = 18) TIPS between July 2014 and June 2016 were retrospectively reviewed. Preprocedure demographics, Child-Pugh, model for end-stage liver disease and technical variables were recorded. Outcomes measured included technical and clinical success, complications, 30-day mortality, as well as necessity for TIPS revision. Average (SD) and median follow-up was 237 (190) and 226 days.
resultsAll constrained and conventional TIPS were technically successful (100%). Clinical success as defined as a reduction or improvement in presenting symptoms was 88.9% (8/9) and 100% (18/18) in the constrained and conventional groups, respectively (p = 1). The average reduction in portosystemic gradient was lower in the constrained group, 6.1 mmHg compared with 10.6 mmHg in the conventional group (p = 0.73). The rate of hepatic encephalopathy following TIPS placement was higher in the conventional group [16.7% (3/18)] compared with 0% in the constrained group (p = 0.52). The percentage of patients requiring TIPS revision was lower in the constrained group, although the results were not significant (11.1 vs 22.2%, p = 0.63).
conclusionPrimary constrained TIPS is a feasible modification to conventional TIPS with similar technical and clinical success rates. A trend towards a smaller reduction in the portosystemic gradient and need for revision was observed in the constrained group. Advances in knowledge: Primary constrained TIPS allows for greater stepwise control over shunt diameter and may represent an improved technique for patients at risk for hepatic encephalopathy.
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