医学
经颈静脉肝内门体分流术
支架
并发症
门脉高压
分流(医疗)
外科
限制
肝性脑病
血管成形术
门静脉
放射科
肝硬化
内科学
机械工程
工程类
作者
Ranjan Kumar Patel,Karamvir Chandel,Taraprasad Tripathy,Amar Mukund
标识
DOI:10.1016/j.ejrad.2021.109986
摘要
Transjugular intrahepatic portosystemic shunt (TIPS) is created between a hepatic vein (HV) and the portal vein (PV) to alleviate the symptoms of portal hypertension. Despite high procedural success rates, a myriad of complications may occur at every step of TIPS creation. These complications may be attributable to the procedure itself or the shunt. Portal vein puncture is the most challenging and rate-limiting step, with extrahepatic portal vein puncture being the most devastating tabletop complication. Hepatic encephalopathy is the most common shunt-related complication after TIPS. Unlike bare metallic stents, covered stents have a longer patency rate and lower incidence of TIPS dysfunction. Most of the TIPS dysfunction that occurs with stent-grafts is due to technical errors and mechanical factors. TIPS revision often requires a combination of angioplasty, mechanical thrombectomy, and thrombolytics with a need for additional stenting in some cases. This review article focuses on procedure and shunt-related complications, as well as preventive and management strategies.
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