The authors studied the clinical and procedural results of transjugular intrahepatic portosystemic stent shunts (TIPSS) procedures in 16 patients,of whom 13 were male,3 were female with mean age of 48 years(range 24-66).
In 18 consecutive patients receiving the transjugular intrahepatic portosystemic stent shunts (TIPSS), 15 were male and 3 female. The patients aged from 34 to 66 years had liver cirrhosis with portal hypertension and ...In 18 consecutive patients receiving the transjugular intrahepatic portosystemic stent shunts (TIPSS), 15 were male and 3 female. The patients aged from 34 to 66 years had liver cirrhosis with portal hypertension and esophageal varices. Twelve had recurrent bleedings from raptured gastroesophageal varices. Shunts were established in 16 of the 18 patients and no operative death was noted. Portal vein pressure was reduced from 3.98± 0.24 kPa before shunting to 2.40±0.16 kPa after shunting. Doppler ultrasound examination revealed that the maximum blood flow velocity in the main portal vein increased from 14.0±4.5 cm / sec to 48.0±16.5 cm / sec. The mean follow-up time in the successful cases was 4.5 months (range 2-8 months). The shunt patency was determined with color Doppler ultrasound in 15 patients: occlusion in one and no accites in 4. Varices disappeared in 8 patients and became less evident in 7. No patients had recurrence of varices bleeding or encephalopathy during follow-up. The results suggest that TIPSS is a safe and effective method for portal decompression in the treatment of variceal hemorrhage, and that portal vein puncture is largely dependent on understanding the three-dimensional relationships between hepatic and portal veins. To achieve an adequate portal decompression, we recommend that a stent of 12 mm in diameter be used in severe cases.展开更多
Transjugular intrahepatic portosystemic stent‐shunt(TIPS)was first reported in 1989 as a nonsurgical percutaneous method for treating patients suffering from severe end‐stage portal hypertension symptoms with Child&...Transjugular intrahepatic portosystemic stent‐shunt(TIPS)was first reported in 1989 as a nonsurgical percutaneous method for treating patients suffering from severe end‐stage portal hypertension symptoms with Child's stage C metabolic status at Freiburg University Hospital in Germany.1 Since then,TIPS has become a unique percutaneous technique for treating portal hypertension,and it has spread throughout the world.In the early 1990s,medical standards in China lagged far behind Western countries,and interventional radiology(IR)depended heavily on imported medical instruments.During that period,IR doctors and scientists who received training abroad came back to China and began to use stenting techniques at a time when imported stent products were extremely scarce.Dr.Ke Xu,who received IR training in Japan in the late 1980s,treated a male patient with cirrhosis combined with repeated hematemesis with TIPS in the First Hospital of China Medical University in June 1992,which was certified the first case of TIPS in China(Figure 1A).展开更多
文摘The authors studied the clinical and procedural results of transjugular intrahepatic portosystemic stent shunts (TIPSS) procedures in 16 patients,of whom 13 were male,3 were female with mean age of 48 years(range 24-66).
文摘In 18 consecutive patients receiving the transjugular intrahepatic portosystemic stent shunts (TIPSS), 15 were male and 3 female. The patients aged from 34 to 66 years had liver cirrhosis with portal hypertension and esophageal varices. Twelve had recurrent bleedings from raptured gastroesophageal varices. Shunts were established in 16 of the 18 patients and no operative death was noted. Portal vein pressure was reduced from 3.98± 0.24 kPa before shunting to 2.40±0.16 kPa after shunting. Doppler ultrasound examination revealed that the maximum blood flow velocity in the main portal vein increased from 14.0±4.5 cm / sec to 48.0±16.5 cm / sec. The mean follow-up time in the successful cases was 4.5 months (range 2-8 months). The shunt patency was determined with color Doppler ultrasound in 15 patients: occlusion in one and no accites in 4. Varices disappeared in 8 patients and became less evident in 7. No patients had recurrence of varices bleeding or encephalopathy during follow-up. The results suggest that TIPSS is a safe and effective method for portal decompression in the treatment of variceal hemorrhage, and that portal vein puncture is largely dependent on understanding the three-dimensional relationships between hepatic and portal veins. To achieve an adequate portal decompression, we recommend that a stent of 12 mm in diameter be used in severe cases.
文摘Transjugular intrahepatic portosystemic stent‐shunt(TIPS)was first reported in 1989 as a nonsurgical percutaneous method for treating patients suffering from severe end‐stage portal hypertension symptoms with Child's stage C metabolic status at Freiburg University Hospital in Germany.1 Since then,TIPS has become a unique percutaneous technique for treating portal hypertension,and it has spread throughout the world.In the early 1990s,medical standards in China lagged far behind Western countries,and interventional radiology(IR)depended heavily on imported medical instruments.During that period,IR doctors and scientists who received training abroad came back to China and began to use stenting techniques at a time when imported stent products were extremely scarce.Dr.Ke Xu,who received IR training in Japan in the late 1980s,treated a male patient with cirrhosis combined with repeated hematemesis with TIPS in the First Hospital of China Medical University in June 1992,which was certified the first case of TIPS in China(Figure 1A).
