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Title of Journal: Cardiovasc Intervent Radiol

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Abbravation: CardioVascular and Interventional Radiology

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Springer US

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DOI

10.1007/bf00743403

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1432-086X

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An Approach to Endovascular and Percutaneous Manag

Authors: Keith Pereira Reginald Baker Jason Salsamendi Mehul Doshi Issam Kably Shivank Bhatia
Publish Date: 2015/11/24
Volume: 39, Issue: 5, Pages: 639-651
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Abstract

Transjugular intrahepatic portosystemic shunts TIPS have evolved as an effective and durable nonsurgical option in the treatment of portal hypertension PH It has been shown to improve survival in decompensated cirrhosis and may also serve as a bridge to liver transplantation In spite of the technical improvements in the procedure problems occur with the shunt which jeopardizes effective treatment of the PH Appropriate management is vital to ensure the longevity of the conduit Shunt revision techniques include endovascular revision techniques and new shunt creation or in the appropriate patients alternative/rescue therapies The ability of interventional radiologists to restore adequate TIPS function has enormous implications for quality of life with palliation morbidity/mortality related to variceal bleeding and survival if transplant candidates can live long enough to receive a new liver As such it is imperative that these treatment strategies are understood and employed when these patients are encountered In this review the restoration of appropriate shunt function using various techniques will be discussed as they apply to a variety of clinical scenarios based on literature In addition illustrative case examples highlighting our experience at an academic tertiary medical center will be included It is the intent to have this document serve as a concise and informative reference to be used by those who may encounter patients with suboptimal functioning TIPSAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards

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