Article
Gastroenterology & Hepatology
Marika Rudler, Virginia Hernandez-Gea, Bogdan Dumitru Procopet, Alvaro Giraldez, Lucio Amitrano, Candid Villanueva, Luis Ibanez, Gilberto Silva-Junior, Joan Genesca, Christophe Bureau, Jonel Trebicka, Rafael Banares, Aleksander Krag, Elba Llop, Wim Laleman, Jose Maria Palazon, Jose Castellote, Susana Rodrigues, Lise Lotte Gluud, Carlos Noronha Ferreira, Nouria Canete, Manuel Rodriguez, Arnulf Ferlitsch, Jose Luis Mundi, Henning Gronbaek, Manuel Hernandez-Guerra, Romano Sassatelli, Alessandra Dell'era, Marco Senzolo, Juan G. Abraldes, Manuel Romero-Gomez, Alexander Zipprich, Meritxell Casas, Helena Masnou, Helene Larrue, Massimo Primignani, Frederik Nevens, Jose Luis Calleja, Remy Schwarzer, Christian Jansen, Marie-Angele Robic, Irene Conejo, Javier Martinez Gonzalez, Maria Vega Catalina, Agustin Albillos, Edilmar Alvarado, Maria Anna Guardascione, Maxime Mallet, Simona Tripon, Georgina Casanovas, Jaume Bosch, Juan-Carlos Garcia-Pagan, Dominique Thabut
Summary: pTIPS is more effective in improving survival compared to endoscopic treatment for high-risk patients with cirrhosis and variceal bleeding. HE at admission does not affect the efficacy of pTIPS.
Article
Gastroenterology & Hepatology
Qiao Ke, Zhiyong Wang, Xinhui Huang, Ling Li, Weimin Wu, Linbin Qiu, Yubin Jiao, Yixing Xie, Xiaosong Peng, Jingfeng Liu, Wuhua Guo
Summary: This study aimed to explore the safety and efficacy of splenic vein embolization (SVE) for hepatic encephalopathy (HE) patients with large spontaneous splenorenal shunts (SSRS). The results demonstrated that SVE could improve HE symptoms and hepatic function, but further validation is required.
ANNALS OF HEPATOLOGY
(2022)
Review
Radiology, Nuclear Medicine & Medical Imaging
Guang-Peng Zhou, Yi-Zhou Jiang, Li-Ying Sun, Zhi-Jun Zhu
Summary: Early transjugular intrahepatic portosystemic shunt (TIPS) placement in cirrhotic patients with acute variceal bleeding (AVB) has shown to significantly reduce mortality, control bleeding, and prevent rebleeding without increasing the risk of hepatic encephalopathy. The survival benefit of early TIPS was observed in high-risk patients, supporting its wider utilization in clinical practice.
EUROPEAN RADIOLOGY
(2021)
Article
Gastroenterology & Hepatology
Yong Lv, Hui Chen, Bohan Luo, Wei Bai, Kai Li, Zhengyu Wang, Dongdong Xia, Wengang Guo, Qiuhe Wang, Xiaomei Li, Jie Yuan, Hongwei Cai, Jielai Xia, Zhanxin Yin, Daiming Fan, Guohong Han
Summary: In patients with cirrhosis and variceal bleeding, simultaneous embolization of large spontaneous portosystemic shunt (SPSS) during transjugular intrahepatic portosystemic shunt (TIPS) placement can reduce the incidence of hepatic encephalopathy (HE) without increasing other complications.
Article
Medicine, General & Internal
Leon Louis Seifert, Philipp Schindler, Martin Schoster, Jan Frederic Weller, Christian Wilms, Hartmut H. Schmidt, Miriam Maschmeier, Max Masthoff, Michael Koehler, Hauke Heinzow, Moritz Wildgruber
Summary: Higher age and previous HE are risk factors for post-TIPS HE. Lactulose monoprophylaxis has no prophylactic effect, while the combination of lactulose and rifaximin can prevent HE recurrence but not in patients without a history of HE.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Gastroenterology & Hepatology
Justin Richard Boike, Nikhilesh Ray Mazumder, Kanti Pallav Kolli, Jin Ge, Margarita German, Nathaniel Jest, Giuseppe Morelli, Erin Spengler, Adnan Said, Jennifer C. Lai, Archita P. Desai, Thomas Couri, Sonali Paul, Catherine Frenette, Elizabeth C. Verna, Usman Rahim, Aparna Goel, Dyanna Gregory, Bartley Thornburg, Lisa B. VanWagner
Summary: This study analyzed the risk factors for post-TIPS mortality and liver transplantation, finding that the relationship with MELD-Na varies depending on the indication for TIPS.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2021)
Review
Gastroenterology & Hepatology
Yu Jun Wong, Wei Ling Danielle Ho, Juan G. Abraldes
Summary: This review summarizes the current evidence and controversies on pre-emptive transjugular intrahepatic portosystemic shunt (p-TIPSS), including patient selection, p-TIPSS in NASH cirrhosis and acute-on-chronic liver failure, the role of sarcopenia and renal impairment in p-TIPSS, and pharmacological and nonpharmacological strategies to optimize outcomes.
JOURNAL OF CLINICAL AND TRANSLATIONAL HEPATOLOGY
(2022)
Review
Gastroenterology & Hepatology
Yu Jun Wong, Wei Ling Danielle Ho, Juan G. Abraldes
Summary: This review summarizes the current evidence and controversies surrounding p-TIPSS, including patient selection criteria, applications in NASH cirrhosis and acute-on-chronic liver failure, as well as strategies to optimize outcomes for patients undergoing p-TIPSS.
JOURNAL OF CLINICAL AND TRANSLATIONAL HEPATOLOGY
(2022)
Article
Gastroenterology & Hepatology
Menghao Li, Kai Li, Shihao Tang, Yong Lv, Qiuhe Wang, Zhengyu Wang, Bohan Luo, Jing Niu, Ying Zhu, Wengang Guo, Wei Bai, Enxin Wang, Dongdong Xia, Zhexuan Wang, Xiaomei Li, Jie Yuan, Zhanxin Yin, Jonel Trebicka, Guohong Han
Summary: This study found that alterations in gut dysbiosis were negatively associated with the occurrence and severity of post-TIPS HE, and improving the microbiota can help reduce the incidence of HE. Analysis of the gut microbiota can be used to screen suitable patients for TIPS and prevent the occurrence of HE.
Review
Medicine, General & Internal
Maria Corina Plaz Torres, Lawrence M. J. Best, Suzanne C. Freeman, Danielle Roberts, Nicola J. Cooper, Alex J. Sutton, Davide Roccarina, Amine Benmassaoud, Laura Iogna Prat, Norman R. Williams, Mario Csenar, Dominic Fritche, Tanjia Begum, Sivapatham Arunan, Maxine Tapp, Elisabeth Jane Milne, Chavdar S. Pavlov, Brian R. Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
Summary: A network meta-analysis was conducted to compare different initial treatments for the secondary prevention of variceal bleeding in cirrhotic patients with a history of oesophageal varices. Variceal band ligation may result in fewer serious adverse events compared to sclerotherapy, while TIPS may lead to a larger decrease in symptomatic rebleed than variceal band ligation. However, there remains considerable uncertainty regarding the effects of interventions across different comparisons. High-quality randomized comparative clinical trials are needed to provide more definitive evidence.
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
(2021)
Article
Radiology, Nuclear Medicine & Medical Imaging
Huzheng Yan, Zhanwang Xiang, Chenghao Zhao, Shuyang Luo, Huan Liu, Mingan Li, Mingsheng Huang
Summary: This study proposed a strategy for creating a 6-mm TIPS and assessed its effectiveness compared to a conventional 8-mm shunt for TIPS-induced hepatic encephalopathy. The results showed that the 6-mm shunt significantly reduced the incidence of overt HE, protected perioperative liver function, and did not affect stent patency or rebleeding rate.
EUROPEAN RADIOLOGY
(2023)
Review
Endocrinology & Metabolism
Silvia Nardelli, Daniele Bellafante, Lorenzo Ridola, Jessica Faccioli, Oliviero Riggio, Stefania Gioia
Summary: Transjugular intrahepatic portosystemic shunt (TIPS) is an effective method for treating complications of portal hypertension, but post-TIPS hepatic encephalopathy is a major complication. Only a few drugs have been proven effective in preventing this complication, so careful selection of high-risk patients is necessary.
METABOLIC BRAIN DISEASE
(2023)
Article
Gastroenterology & Hepatology
Fangfang Yi, Xiaozhong Guo, Le Wang, Xiangbo Xu, Yang An, Yufu Tang, Wenwen Zhang, Frank Tacke, Ankur Arora, Xingshun Qi
Summary: The study demonstrated that spontaneous splenorenal shunt (SSRS) may worsen liver function and increase mortality in liver cirrhosis by narrowing portal vein diameter and shrinking liver volume.
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
(2021)
Article
Gastroenterology & Hepatology
Linhao Zhang, Bo Wei, Zhidong Wang, Huan Tong, Hao Wu
Summary: This study compared the clinical outcomes of embolization of the shunt (ES) and selective embolization of the splenic vein (SESV) for the treatment of spontaneous portosystemic shunt (SPSS)-induced refractory hepatic encephalopathy (HE) in cirrhotic patients. The results showed that the 6-month mortality was significantly lower after SESV compared to ES. Additionally, ES was associated with lower white blood cell and platelet counts, and higher aspartate aminotransferase levels, while SESV led to significant improvements in albumin levels, Child-Pugh score, and grade at 6 months.
DIGESTIVE AND LIVER DISEASE
(2023)
Review
Endocrinology & Metabolism
Wim Laleman, Michael Praktiknjo, Mette Munk Lauridsen, Lawrence Bonne, Emma Vanderschueren, Chris Verslype, Aleksander Krag, Jonel Trebicka, Geert Maleux
Summary: Spontaneous portosystemic shunts are often overlooked as a cause of hepatic encephalopathy associated with cirrhosis. They are considered as radiological biomarkers of clinically significant portal hypertension and have a clinical impact on complications related to portal hypertension. Interventional radiology embolization is a direct method to target these shunts.
METABOLIC BRAIN DISEASE
(2023)
