Transjugular intrahepatic portosystemic shunt in patients with cirrhosis: Indications and posttransjugular intrahepatic portosystemic shunt complications in 2020

Transjugular intrahepatic portosystemic shunt is a percutaneous radiologic‐guided procedure that aims to reduce portal hypertension by creating a shunt between the portal venous system and the hepatic venous system. The most common cause of portal hypertension is liver cirrhosis in Western countries...

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Bibliographic Details
Published in:United European gastroenterology journal 2021-03, Vol.9 (2), p.203-208
Main Authors: Horhat, Adelina, Bureau, Christophe, Thabut, Dominique, Rudler, Marika
Format: Article
Language:English
Subjects:
Antibiotics
Ascites
Ascites - etiology
Contraindications, Procedure
Disease prevention
Endoscopy
Gastrointestinal Hemorrhage - etiology
Human health and pathology
Humans
Hypertension
Hypertension, Portal - etiology
Hypertension, Portal - surgery
Life Sciences
Liver
Liver cirrhosis
Liver Cirrhosis, Alcoholic - complications
Liver Cirrhosis, Alcoholic - surgery
Liver diseases
Liver Failure - etiology
Liver transplants
Male
Medical prognosis
Middle Aged
Mortality
Patients
portal hypertension
Portasystemic Shunt, Transjugular Intrahepatic - adverse effects
Postoperative Complications
posttransjugular intrahepatic portosystemic shunt encephalopathy
pre‐emptive TIPS
Recurrence
refractory ascites
Review
Risk Factors
Salvage Therapy - adverse effects
Secondary Prevention
transjugular intrahepatic portosystemic shunt
variceal bleeding
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Summary:Transjugular intrahepatic portosystemic shunt is a percutaneous radiologic‐guided procedure that aims to reduce portal hypertension by creating a shunt between the portal venous system and the hepatic venous system. The most common cause of portal hypertension is liver cirrhosis in Western countries. Two main indications of transjugular intrahepatic portosystemic shunt are validated by randomised controlled studies in patients with cirrhosis and variceal bleeding (salvage transjugular intrahepatic portosystemic shunt, early transjugular intrahepatic portosystemic shunt or rebleeding despite an optimal secondary prophylaxis) or refractory ascites. Careful selection of the patients is crucial in order to prevent posttransjugular intrahepatic portosystemic shunt complications, including liver failure, posttransjugular intrahepatic portosystemic shunt encephalopathy occurrence and cardiac decompensation, for a better long‐term outcome. In this review, we will discuss transjugular intrahepatic portosystemic shunt indications in 2020 in patients with cirrhosis and portal hypertension, with a special focus on variceal bleeding and refractory ascites. Then, we will describe transjugular intrahepatic portosystemic shunt‐related complications, the contraindications and the current knowledge on patient's selection.
ISSN:2050-6406
2050-6414
DOI:10.1177/2050640620952637