Small diameter shunts should lead to safe expansion of the use of TIPS

Transjugular intrahepatic portosystemic shunt (TIPS) is increasingly used worldwide to treat the complications of portal hypertension in patients with advanced cirrhosis. However, its use is hampered by the risk of causing hepatic encephalopathy and of worsening liver function. The reported haemodyn...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Bosch, Jaume [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2020

Schlagwörter:	Cirrhosis Portal hypertension Ascites Variceal bleeding Hepatic encephalopathy Rifaximin Propranolol Embolisation of portosystemic collaterals Splenic artery embolisation

Übergeordnetes Werk:	Enthalten in: Journal of hepatology - Amsterdam [u.a.] : Elsevier Science, 1985, 74
Übergeordnetes Werk:	volume:74

DOI / URN:	10.1016/j.jhep.2020.09.018

Katalog-ID:	ELV005231116

Internformat


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520			\|a Transjugular intrahepatic portosystemic shunt (TIPS) is increasingly used worldwide to treat the complications of portal hypertension in patients with advanced cirrhosis. However, its use is hampered by the risk of causing hepatic encephalopathy and of worsening liver function. The reported haemodynamic targets used to guide TIPS are too narrow to be achieved in most cases and are perhaps not entirely adequate nowadays as they were obtained in the pre-covered stent era. We propose that small diameter TIPS – alone or combined to pharmacological therapy or ancillary interventional radiology procedures – may overcome these limitations while maintaining the beneficial effects of the procedure.
650		4	\|a Cirrhosis
650		4	\|a Portal hypertension
650		4	\|a Ascites
650		4	\|a Variceal bleeding
650		4	\|a Hepatic encephalopathy
650		4	\|a Rifaximin
650		4	\|a Propranolol
650		4	\|a Embolisation of portosystemic collaterals
650		4	\|a Splenic artery embolisation
773	0	8	\|i Enthalten in \|t Journal of hepatology \|d Amsterdam [u.a.] : Elsevier Science, 1985 \|g 74 \|h Online-Ressource \|w (DE-627)320984486 \|w (DE-600)2027112-8 \|w (DE-576)093888856 \|x 1600-0641 \|7 nnns
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912			\|a GBV_ILN_602
912			\|a GBV_ILN_702
912			\|a GBV_ILN_2003
912			\|a GBV_ILN_2004
912			\|a GBV_ILN_2005
912			\|a GBV_ILN_2011
912			\|a GBV_ILN_2014
912			\|a GBV_ILN_2015
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912			\|a GBV_ILN_2034
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912			\|a GBV_ILN_2061
912			\|a GBV_ILN_2064
912			\|a GBV_ILN_2065
912			\|a GBV_ILN_2068
912			\|a GBV_ILN_2111
912			\|a GBV_ILN_2112
912			\|a GBV_ILN_2113
912			\|a GBV_ILN_2118
912			\|a GBV_ILN_2122
912			\|a GBV_ILN_2129
912			\|a GBV_ILN_2143
912			\|a GBV_ILN_2147
912			\|a GBV_ILN_2148
912			\|a GBV_ILN_2152
912			\|a GBV_ILN_2153
912			\|a GBV_ILN_2190
912			\|a GBV_ILN_2336
912			\|a GBV_ILN_2507
912			\|a GBV_ILN_2522
912			\|a GBV_ILN_4035
912			\|a GBV_ILN_4037
912			\|a GBV_ILN_4112
912			\|a GBV_ILN_4125
912			\|a GBV_ILN_4126
912			\|a GBV_ILN_4242
912			\|a GBV_ILN_4251
912			\|a GBV_ILN_4305
912			\|a GBV_ILN_4313
912			\|a GBV_ILN_4323
912			\|a GBV_ILN_4324
912			\|a GBV_ILN_4325
912			\|a GBV_ILN_4326
912			\|a GBV_ILN_4333
912			\|a GBV_ILN_4334
912			\|a GBV_ILN_4335
912			\|a GBV_ILN_4338
912			\|a GBV_ILN_4393
936	b	k	\|a 44.87 \|j Gastroenterologie
951			\|a AR
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publishDate	2020
allfields	10.1016/j.jhep.2020.09.018 doi (DE-627)ELV005231116 (ELSEVIER)S0168-8278(20)33662-X DE-627 ger DE-627 rda eng 610 DE-600 44.87 bkl Bosch, Jaume verfasserin (orcid)0000-0003-3414-0055 aut Small diameter shunts should lead to safe expansion of the use of TIPS 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Transjugular intrahepatic portosystemic shunt (TIPS) is increasingly used worldwide to treat the complications of portal hypertension in patients with advanced cirrhosis. However, its use is hampered by the risk of causing hepatic encephalopathy and of worsening liver function. The reported haemodynamic targets used to guide TIPS are too narrow to be achieved in most cases and are perhaps not entirely adequate nowadays as they were obtained in the pre-covered stent era. We propose that small diameter TIPS – alone or combined to pharmacological therapy or ancillary interventional radiology procedures – may overcome these limitations while maintaining the beneficial effects of the procedure. Cirrhosis Portal hypertension Ascites Variceal bleeding Hepatic encephalopathy Rifaximin Propranolol Embolisation of portosystemic collaterals Splenic artery embolisation Enthalten in Journal of hepatology Amsterdam [u.a.] : Elsevier Science, 1985 74 Online-Ressource (DE-627)320984486 (DE-600)2027112-8 (DE-576)093888856 1600-0641 nnns volume:74 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.87 Gastroenterologie AR 74
spelling	10.1016/j.jhep.2020.09.018 doi (DE-627)ELV005231116 (ELSEVIER)S0168-8278(20)33662-X DE-627 ger DE-627 rda eng 610 DE-600 44.87 bkl Bosch, Jaume verfasserin (orcid)0000-0003-3414-0055 aut Small diameter shunts should lead to safe expansion of the use of TIPS 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Transjugular intrahepatic portosystemic shunt (TIPS) is increasingly used worldwide to treat the complications of portal hypertension in patients with advanced cirrhosis. However, its use is hampered by the risk of causing hepatic encephalopathy and of worsening liver function. The reported haemodynamic targets used to guide TIPS are too narrow to be achieved in most cases and are perhaps not entirely adequate nowadays as they were obtained in the pre-covered stent era. We propose that small diameter TIPS – alone or combined to pharmacological therapy or ancillary interventional radiology procedures – may overcome these limitations while maintaining the beneficial effects of the procedure. Cirrhosis Portal hypertension Ascites Variceal bleeding Hepatic encephalopathy Rifaximin Propranolol Embolisation of portosystemic collaterals Splenic artery embolisation Enthalten in Journal of hepatology Amsterdam [u.a.] : Elsevier Science, 1985 74 Online-Ressource (DE-627)320984486 (DE-600)2027112-8 (DE-576)093888856 1600-0641 nnns volume:74 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.87 Gastroenterologie AR 74
allfields_unstemmed	10.1016/j.jhep.2020.09.018 doi (DE-627)ELV005231116 (ELSEVIER)S0168-8278(20)33662-X DE-627 ger DE-627 rda eng 610 DE-600 44.87 bkl Bosch, Jaume verfasserin (orcid)0000-0003-3414-0055 aut Small diameter shunts should lead to safe expansion of the use of TIPS 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Transjugular intrahepatic portosystemic shunt (TIPS) is increasingly used worldwide to treat the complications of portal hypertension in patients with advanced cirrhosis. However, its use is hampered by the risk of causing hepatic encephalopathy and of worsening liver function. The reported haemodynamic targets used to guide TIPS are too narrow to be achieved in most cases and are perhaps not entirely adequate nowadays as they were obtained in the pre-covered stent era. We propose that small diameter TIPS – alone or combined to pharmacological therapy or ancillary interventional radiology procedures – may overcome these limitations while maintaining the beneficial effects of the procedure. Cirrhosis Portal hypertension Ascites Variceal bleeding Hepatic encephalopathy Rifaximin Propranolol Embolisation of portosystemic collaterals Splenic artery embolisation Enthalten in Journal of hepatology Amsterdam [u.a.] : Elsevier Science, 1985 74 Online-Ressource (DE-627)320984486 (DE-600)2027112-8 (DE-576)093888856 1600-0641 nnns volume:74 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.87 Gastroenterologie AR 74
allfieldsGer	10.1016/j.jhep.2020.09.018 doi (DE-627)ELV005231116 (ELSEVIER)S0168-8278(20)33662-X DE-627 ger DE-627 rda eng 610 DE-600 44.87 bkl Bosch, Jaume verfasserin (orcid)0000-0003-3414-0055 aut Small diameter shunts should lead to safe expansion of the use of TIPS 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Transjugular intrahepatic portosystemic shunt (TIPS) is increasingly used worldwide to treat the complications of portal hypertension in patients with advanced cirrhosis. However, its use is hampered by the risk of causing hepatic encephalopathy and of worsening liver function. The reported haemodynamic targets used to guide TIPS are too narrow to be achieved in most cases and are perhaps not entirely adequate nowadays as they were obtained in the pre-covered stent era. We propose that small diameter TIPS – alone or combined to pharmacological therapy or ancillary interventional radiology procedures – may overcome these limitations while maintaining the beneficial effects of the procedure. Cirrhosis Portal hypertension Ascites Variceal bleeding Hepatic encephalopathy Rifaximin Propranolol Embolisation of portosystemic collaterals Splenic artery embolisation Enthalten in Journal of hepatology Amsterdam [u.a.] : Elsevier Science, 1985 74 Online-Ressource (DE-627)320984486 (DE-600)2027112-8 (DE-576)093888856 1600-0641 nnns volume:74 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.87 Gastroenterologie AR 74
allfieldsSound	10.1016/j.jhep.2020.09.018 doi (DE-627)ELV005231116 (ELSEVIER)S0168-8278(20)33662-X DE-627 ger DE-627 rda eng 610 DE-600 44.87 bkl Bosch, Jaume verfasserin (orcid)0000-0003-3414-0055 aut Small diameter shunts should lead to safe expansion of the use of TIPS 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Transjugular intrahepatic portosystemic shunt (TIPS) is increasingly used worldwide to treat the complications of portal hypertension in patients with advanced cirrhosis. However, its use is hampered by the risk of causing hepatic encephalopathy and of worsening liver function. The reported haemodynamic targets used to guide TIPS are too narrow to be achieved in most cases and are perhaps not entirely adequate nowadays as they were obtained in the pre-covered stent era. We propose that small diameter TIPS – alone or combined to pharmacological therapy or ancillary interventional radiology procedures – may overcome these limitations while maintaining the beneficial effects of the procedure. Cirrhosis Portal hypertension Ascites Variceal bleeding Hepatic encephalopathy Rifaximin Propranolol Embolisation of portosystemic collaterals Splenic artery embolisation Enthalten in Journal of hepatology Amsterdam [u.a.] : Elsevier Science, 1985 74 Online-Ressource (DE-627)320984486 (DE-600)2027112-8 (DE-576)093888856 1600-0641 nnns volume:74 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.87 Gastroenterologie AR 74
language	English
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topic_facet	Cirrhosis Portal hypertension Ascites Variceal bleeding Hepatic encephalopathy Rifaximin Propranolol Embolisation of portosystemic collaterals Splenic artery embolisation
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author	Bosch, Jaume
spellingShingle	Bosch, Jaume ddc 610 bkl 44.87 misc Cirrhosis misc Portal hypertension misc Ascites misc Variceal bleeding misc Hepatic encephalopathy misc Rifaximin misc Propranolol misc Embolisation of portosystemic collaterals misc Splenic artery embolisation Small diameter shunts should lead to safe expansion of the use of TIPS
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topic_title	610 DE-600 44.87 bkl Small diameter shunts should lead to safe expansion of the use of TIPS Cirrhosis Portal hypertension Ascites Variceal bleeding Hepatic encephalopathy Rifaximin Propranolol Embolisation of portosystemic collaterals Splenic artery embolisation
topic	ddc 610 bkl 44.87 misc Cirrhosis misc Portal hypertension misc Ascites misc Variceal bleeding misc Hepatic encephalopathy misc Rifaximin misc Propranolol misc Embolisation of portosystemic collaterals misc Splenic artery embolisation
topic_unstemmed	ddc 610 bkl 44.87 misc Cirrhosis misc Portal hypertension misc Ascites misc Variceal bleeding misc Hepatic encephalopathy misc Rifaximin misc Propranolol misc Embolisation of portosystemic collaterals misc Splenic artery embolisation
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title	Small diameter shunts should lead to safe expansion of the use of TIPS
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title_full	Small diameter shunts should lead to safe expansion of the use of TIPS
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title_sort	small diameter shunts should lead to safe expansion of the use of tips
title_auth	Small diameter shunts should lead to safe expansion of the use of TIPS
abstract	Transjugular intrahepatic portosystemic shunt (TIPS) is increasingly used worldwide to treat the complications of portal hypertension in patients with advanced cirrhosis. However, its use is hampered by the risk of causing hepatic encephalopathy and of worsening liver function. The reported haemodynamic targets used to guide TIPS are too narrow to be achieved in most cases and are perhaps not entirely adequate nowadays as they were obtained in the pre-covered stent era. We propose that small diameter TIPS – alone or combined to pharmacological therapy or ancillary interventional radiology procedures – may overcome these limitations while maintaining the beneficial effects of the procedure.
abstractGer	Transjugular intrahepatic portosystemic shunt (TIPS) is increasingly used worldwide to treat the complications of portal hypertension in patients with advanced cirrhosis. However, its use is hampered by the risk of causing hepatic encephalopathy and of worsening liver function. The reported haemodynamic targets used to guide TIPS are too narrow to be achieved in most cases and are perhaps not entirely adequate nowadays as they were obtained in the pre-covered stent era. We propose that small diameter TIPS – alone or combined to pharmacological therapy or ancillary interventional radiology procedures – may overcome these limitations while maintaining the beneficial effects of the procedure.
abstract_unstemmed	Transjugular intrahepatic portosystemic shunt (TIPS) is increasingly used worldwide to treat the complications of portal hypertension in patients with advanced cirrhosis. However, its use is hampered by the risk of causing hepatic encephalopathy and of worsening liver function. The reported haemodynamic targets used to guide TIPS are too narrow to be achieved in most cases and are perhaps not entirely adequate nowadays as they were obtained in the pre-covered stent era. We propose that small diameter TIPS – alone or combined to pharmacological therapy or ancillary interventional radiology procedures – may overcome these limitations while maintaining the beneficial effects of the procedure.
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title_short	Small diameter shunts should lead to safe expansion of the use of TIPS
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up_date	2024-07-06T17:15:47.869Z
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However, its use is hampered by the risk of causing hepatic encephalopathy and of worsening liver function. The reported haemodynamic targets used to guide TIPS are too narrow to be achieved in most cases and are perhaps not entirely adequate nowadays as they were obtained in the pre-covered stent era. 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Small diameter shunts should lead to safe expansion of the use of TIPS

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