Copyright
©2012 Baishideng Publishing Group Co.
World J Hepatol. Feb 27, 2012; 4(2): 35-42
Published online Feb 27, 2012. doi: 10.4254/wjh.v4.i2.35
Published online Feb 27, 2012. doi: 10.4254/wjh.v4.i2.35
Patient | Sex, age (yr) | Underlying condition | Indication for TIPS | Previous treatment | Child pugh score | MELD score | Survival post shunt | Complications and follow-up |
1 | F (76) | Hepatitis B | Hydrothorax, refractory ascites | Numerous thoracenteses, furosemide | B (9) | 9 | 25 mo, expired | transient encephalopathy (grade 1 to 2) 1 episode < 30 d, 6 episodes over 24 mo, pulm, edema x 1 |
2 | M (78) | Celiac sprue | Refractory ascites | Numerous paracenteses, spironolactone | C (10) | 7 | 41 mo, expired | Encephalopathy (grade 1 to 2) > 30 d 6 episodes over 40 mo |
3 | M (71) | Cryptogenic cirrhosis | Refractory ascites | Numerous paracenteses, spironolactone | B (8) | 16 | 8 mo, expired | None |
4 | F (80) | Cryptogenic cirrhosis | Hepatic hydrothorax | Numerous thoracenteses, spironolactone | C (11) | 11 | 3.5 mo, expired | Encephalopathy transient grade 1 (2 episodes at 30 d and 3 mo) |
5 | M (69) | Sclerosing cholangitis | Refractory ascites | Numerous paracenteses, spironolactone | C (12) | 17 | 3 mo, expired post attempted shunt | None |
6 | M (65) | Alcoholic cirrhosis | Hepatic hydrothorax | Numerous thoracenteses, spironolactone, lasix | B (9) | 15 | 19 mo liver transplant, still alive | Encephalopathy transient grade 1 (1 episode > 30 d and < 3 mo) |
7 | M (71) | Alcoholic cirrhosis | Refractory ascites | Numerous paracenteses, spironolactone, lasix | C (10) | 13 | 3 mo, expired | Encephalopathy transient grade 1 (3 episodes > 30 d) |
8 | F (70) | Hepatitis C | Refractory ascites, skin breakdown | Numerous paracenteses, spironolactone, lasix | B (8) | 9 | 2nd TIPS placed at 21 mo due to occlusion of 1st TIPS expired 47 mo post initial TIPS | None |
9 | F (66) | Hepatitis C | Acute bleeding | B (7) | 9 | Lost to fu pt in Spain | None | |
10 | F (72) | Cryptogenic | Acute bleeding, refractory ascites | Paracentesis, propanolol, lactulose, protonix | B (9) | 12 | 10 mo lost to fu | None |
11 | F (72) | Hepatitis C | Acute bleeding | Sclerotherapy, spleno-renal shunt × 2, numerous paracentesis, lasix, spironolactone | B (8) | 9 | Liver transplant 18 mo after TIPS, still alive | None |
12 | F (67) | Hepatitis B portal vein thrombois | Acute bleeding | Octreotide, protonix | C (10) | 10 | Liver transplant 16 mo after TIPS, still alive | None |
13 | M (74) | Hepatitis C (end stage liver disease) | Refractory ascites | Aldactone, lasix, lactulose, protonix | B (8) | 15 | 2 wk, expired | Transient encephalopathy grade 1 (< 2 wk) |
14 | F (68) | Hepatitis C | Acute bleeding | Midodrine | B (7) | 24 | 2 mo, expired | Recurrent GI bleed 3 wk required revision |
15 | M (69) | Cryptogenic | Acute bleeding | 4 unsuccessful banding, lasix, spironolactone, lactulose, paracentesis | C (10) | 21 | Revision required 48 h after liver transplant 11 mo after revision, still alive | Continued bleed after 1st TIPS, stopped after revision |
16 | F (73) | NASH cirrhosis | Acute bleeding | Octreotide, protonix, spironolactone, lasix | B (9) | 11 | 25 mo, still alive | Minimal ascites |
17 | M (71) | Cryptogenic | Acute bleeding | Band ligation-not successful | B (8) | 16 | Lost to fu | None |
18 | M (82) | Cryptogenic | Refractory ascites, acute bleeding | Numerous paracentesis, lasix, amiloride | B (9) | 16 | 2 wk expired (AV block-DNR/DNI ) | None |
19 | M (73) | Hepatitis C | Refractory ascites | Numerous paracenteses, Spironolactone, lasix s/p kidney and liver tx | B (9) | 14 | 1 mo lost to fu | None |
20 | F (78) | Hepatitis C | Acute bleeding, refractory ascites | B (8) | 18 | 5 d, expired | Post-procedural bleeding, encephalopathy (< 30 d), ascites | |
21 | M (71) | Cirrhosis | Acute bleeding | B (8) | 11 | Status unknown, discharged to rehabilitation hospital | None | |
22 | M (66) | Alcoholic cirrhosis, s/p liver transplant, portal vein thrombosis | Refractory ascites | Lasix | B (9) | 8 | Unknown | Failed attempted TIPS |
23 | M (76) | Alcoholic cirrhosis | Refractory ascites | Numerous paracenteses (once a week) | B(8) | 12 | 15 mo, still alive | None |
Patient | Procedure time (min) | Success | No. of stents | Stent type (mm) | Balloon size (mm) | Portosystemic gradient (mmHg) | Revision dates |
1 | 195 | No | N/A | N/A | N/A | N/A | |
1 | 150 | Yes | 2 | 10 × 68 | 10 | 6-9 | |
2 | 160 | Yes | 2 | 10 × 68 | 8 | 8 | |
Revision 2 | 165 | Yes | 1 | 12 × 90 | 10 | 5 | Revision 3 wk |
Revision 2 | 105 | Yes | 1 | 12 × 90 | 10 | 10-12 | Revision 8 mo |
Revision 2 | 90 | Yes | 1 | 12 × 90 | 10 | 6-8 | Revision 32 mo |
3 | 140 | Yes | 1 | 12 × 90 | 10 | 3-4 | |
4 | 65 | Yes | 1 | 10 × 94 | 8 | 3-5 | |
5 | 127 | No | N/A | N/A | N/A | N/A | |
6 | 165 | Yes | 1 | 10 × 601 | 8 | 12 | |
7 | 235 | Yes | 1 | 10 × 701 | 8 | 13 | |
8 | 135 | Yes | 2 | 8 × 601 | 8 | 12 | |
Revision 8 | 120 | Yes | 2 | 8 × 61 | 8 | 10 | New Parallel TIPS 21 mo |
9 | 15 | Yes | 1 | 8 × 701 | 8 | 5 | |
10 | Unavailable | Yes | 1 | 10 × 801 | 10 | 7 | |
Revision 10 | 50 | Yes | 1 | Unavailable | Unavailable | Unavailable | Revision 10 mo |
11 | 50 | Yes | 2 | 10 × 801 | 10 | 10 | |
12 | 70 | Yes | 1 | 10 × 801 | 10 | 4 | |
13 | 150 | Yes | 1 | 10 × 801 | 10 | 3 | |
14 | 35 | Yes | 1 | 10 × 601 | 10 | 6 | |
Revision 14 | Unavailable | Yes | 1 | Unavailable | Unavailable | Unavailable | Revision 3 wk |
15 | 35 | Yes | 1 | 10 × 701 | 10 | 13 | |
Revision 15 | 18 | Yes | 1 | Unavailable | Unavailable | Unavailable | Revision 48 h |
16 | 55 | Yes | 1 | 10 × 801 | 10 | 2 | |
17 | 65 | Yes | 1 | 10 × 801 | 10 | 8 | |
18 | 30 | Yes | 1 | 10 × 801 | 10 | 4 | |
19 | 85 | Yes | 2 | 10 × 601 | 10 | 4 | |
Revision 19 | Unavailable | Yes | 1 | 12 × 601 | 10 | Unavailable | Unavailable |
20 | Unavailable | Yes | 1 | 10 × 801 | 8 | 4 | |
21 | Unavailable | Yes | 1 | 8 × 801 | 8 | 2 | |
22 | Unavailable | No | N/A | N/A | N/A | N/A | |
23 | 135 | Yes | 1 | 10 × 701 | 8 | 8 |
Patient | |
1 | Hypothyroidism, diabetes mellitus, hypertension, chronic GI bleed, hypoxemia on home oxygen |
2 | Celiac sprue, recurrent chronic bleeding from esophageal varices |
3 | Congestive heart failure, s/p CABG, s/p mitral valve replacement, chronic atrial fibrillation, hypertension |
4 | Aortic stenosis |
5 | Noninsulin dependent diabetes mellitus, chronic renal failure, cholecystectomy, bilateral hernia repair |
6 | None |
7 | None |
8 | None |
9 | None |
10 | Status post lumpectomy, diabetes type 2, basal cell carcinoma of the skin, some masculinizing tumor of the ovary for which the patient has had a bilateral salpingo-oopherectomy, hypertension |
11 | Cholecystectomy, diabetes mellitus |
12 | Breast cancer in 1996 status post modified radical mastectomy, history of portal vein thrombosis in 2002 secondary to tamoxifen |
13 | Aortic stenosis; coronary artery disease, status post 3-vessel CABG; diabetes mellitus; and bilateral lower extremity cellulitis. |
14 | End-stage renal, diabetes, GERD, diverticulitis |
15 | Hypertension |
16 | Coronary artery disease (CAD), hyperlipidemia, Anemia |
17 | Peptic ulcer disease, obstructive sleep apnea, gastroesophageal reflux disease, myeloproliferative disorder, diabetes, aortic stenosis, status post aortic valve replacement in 1996, coronary artery disease |
18 | Severe aortic stenosis, chronic renal insufficiency, BPH, sinus bradycardia with mobitz type I AV block |
19 | Renal failure, status post transplant, cryoglobulinemia, BPH, hypothyroidism |
20 | Hypothyroid, coagulopathy |
21 | Prostate cancer, CHF, AFib, COPD, hypertension, CVA, respiratory failure, history of MRSA and VRE |
22 | Spontaneous bacterial peritonitis, status post liver transplant, hypertension, diabetes, portal vein thrombosis |
23 | CAD, hiatal hernia |
- Citation: Syed MI, Karsan H, Ferral H, Shaikh A, Waheed U, Akhter T, Gabbard A, Morar K, Tyrrell R. Transjugular intrahepatic porto-systemic shunt in the elderly: Palliation for complications of portal hypertension. World J Hepatol 2012; 4(2): 35-42
- URL: https://www.wjgnet.com/1948-5182/full/v4/i2/35.htm
- DOI: https://dx.doi.org/10.4254/wjh.v4.i2.35