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
Autor*in: |
Bosch, Jaume [verfasserIn] |
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Format: |
E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2020 |
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Schlagwörter: |
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Übergeordnetes Werk: |
Enthalten in: Journal of hepatology - Amsterdam [u.a.] : Elsevier Science, 1985, 74 |
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Übergeordnetes Werk: |
volume:74 |
DOI / URN: |
10.1016/j.jhep.2020.09.018 |
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Katalog-ID: |
ELV005231116 |
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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 | |
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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 |
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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 |
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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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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 |
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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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7.3986826 |