Transjugular intrahepatic portosystemic stent shunt: effects on hemodynamics and sodium homeostasis in cirrhosis and refractory ascites

Article Abstract:

Patients should be carefully screened for cardiac stability before inserting a transjugular intrahepatic portosystemic stent shunt (TIPS). TIPS is inserted into the vein leading to the liver and dilated using a balloon method. This shunt can significantly reduce the buildup of abdominal fluids associated with liver cirrhosis. It can also increase the levels of sodium output in the urine. However, heart function may be compromised. In a study. Seven patients with liver cirrhosis and abdominal edema resistant to treatment had this shunt inserted. All symptoms of edema disappeared in four patients, two patients experienced a notable decrease in their edema, and one patient died due to other complications. One month following insertion, sodium excretion also increased four-fold. However, the amount of blood pumped by the patients' hearts increased 74%.

Methods, Physiological aspects, Metabolic regulation, Liver cirrhosis, Hemodynamic monitoring, Natriuresis, Arteriovenous shunts, Surgical, Surgical arteriovenous shunts

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Transjugular intrahepatic portosystemic shunt versus sclerotherapy: a discussion of discordant results

Article Abstract:

Four studies examining the relative effectiveness of sclerotherapy and a surgical technique to divert blood flow in bleeding liver vessels called transjugular intrahepatic portosystemic shunt (TIPS) appear to be inconclusive. Sclerotherapy involves injecting chemicals to harden affected vessels. Some studies have shown TIPS therapy to be more effective in reducing bleeding episodes. Others have shown the therapies to be equally effective. Death rates tend to be higher for patients treated with a TIPS. Studies combining these data may indicate the better therapy. Meanwhile, doctors should choose therapies on an individual basis.

Editorial

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Endoscopic sclerotherapy compared with percutaneous transjugular intrahepatic portosystemic shunt after initial sclerotherapy in patients with acute variceal hemorrhage: a randomized, controlled trial

Article Abstract:

A technique that redirects blood flow in bleeding liver vessels called transjugular intrahepatic portosystemic shunt (TIPS) may be more effective in controlling bleeding as an injection therapy called sclerotherapy and may result in longer survival. Rates of survival, re-bleeding, and other complicating factors were analyzed among 24 patients treated with TIPS and 25 patients treated with sclerotherapy. Patients treated with TIPS had lower rates of re-bleeding episodes and tended to live longer during a mean of 575 days of observation following treatment. Other comparisons were similar for the two groups.

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