Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Purpose: The purpose of the study was to investigate outcome after pediatric transjugular intrahepatic portosystemic shunt (TIPS) with respect to survival MATERIAL AND METHODS: After searching for studies on TIPS in children in Ovid, Medline, Embase, Scopus and Cochrane published between 2000 and 2022, individual patient data were retrieved from five retrospective cohorts. Overall survival (OS) and transplant-free survival (TFS) were calculated using Kaplan-Meier analysis and log-rank test and compared to the indication (ascites vs. variceal bleeding) as well as to the level of obstruction (pre-hepatic vs. hepatic vs. post-hepatic). Additionally, TIPS patency was analyzed.
Results: n = 135 pediatric patients were included in the final analysis. Indication for pediatric TIPS creation was heterogeneous among the included studies. TIPS patency decreased from 6 to 24 months, subsequent pediatric liver transplantation was performed in 22/135 (16.3%) of cases. The presence of ascites was related with poorer TFS (HR 2.3, p = 0.023), while variceal bleeding was not associated with impaired survival. Analysis of the level of obstruction (pre-hepatic, hepatic and post-hepatic) failed to prove significantly reduced OS for post-hepatic obstruction (HR 3.2, p = 0.092) and TFS (HR 1.3, p = 0.057). There was no difference in OS and TFS according to age at time of TIPS placement.
Conclusions: The presence of ascites associates with impaired survival after TIPS in children, with no differences in survival according to the age of the child. Interventional shunt procedures can be considered feasible for all ages.
Level Of Evidence: Level 2a.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10471675 | PMC |
| http://dx.doi.org/10.1007/s00270-023-03520-z | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Use of Partial Splenic Embolization Following a Transjugular Intrahepatic Portosystemic Shunt to Reduce Persistent Portal Hypertension Sequelae.
Cureus
August 2025
Interventional Radiology, Sacred Heart Hospital, Pensacola, USA.
Transjugular intrahepatic portosystemic shunt (TIPS) placement is a well-established intervention for portal hypertension. However, some patients experience persistent complications such as encephalopathy, ascites, or thrombocytopenia, especially when further TIPS optimization is not technically possible. Partial splenic embolization (PSE), typically performed for hypersplenism or certain hematologic conditions, can reduce portal venous inflow and improve cytopenias; however, its use as an adjunct to TIPS is less well described.
View Article and Find Full Text PDFAn Unusual Cause of Massive Per Vaginal Bleeding.
ACG Case Rep J
October 2024
Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore.
Massive per vaginal bleeding from ectopic pelvic varices is an exceedingly rare presentation in patients with cirrhosis. A 60-year-old postmenopausal woman presented with massive per vaginal (PV) bleeding. Computerized tomography scan showed extensive portosystemic collaterals with a large collateral vessel from the splenic vein to the region of her previous caesarean scar, on a background of liver cirrhosis.
View Article and Find Full Text PDFEffectiveness of controlled-expansion transjugular intrahepatic portosystemic shunt (CX-TIPS) in an interdisciplinary setting at a large tertiary center.
Wien Klin Wochenschr
September 2025
Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Introduction: The use of controlled-expansion transjugular intrahepatic portosystemic shunt (CX-TIPS) effectively controls portal hypertension (PH)-related complications while reducing risks related to fully expanded stents. We evaluated the effectiveness of CX-TIPS in a large Viennese patient cohort.
Method: We assessed the number of patients evaluated for CX-TIPS placement by interdisciplinary discussion at the Medical University of Vienna and included all patients from the prospective AUTIPS registry undergoing CX-TIPS placement between June 2018 - December 2024.
Risk factors for hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in cirrhotic patients: A comprehensive minireview.
World J Hepatol
August 2025
Department of Interventional Radiology, Jiangyin Hospital Affiliated to Nantong University, Jiangyin 214400, Jiangsu Province, China.
Transjugular intrahepatic portosystemic shunt (TIPS) is widely used to treat portal hypertension and its complications patients with cirrhosis. However, managing post-TIPS hepatic encephalopathy (HE) remains a major clinical challenge. HE is characterized by a high incidence and a complex pathogenesis, influenced by various factors.
View Article and Find Full Text PDFOptimal guiding methods for transjugular intrahepatic portosystemic shunt creation: Characteristics of intravascular ultrasound other techniques.
World J Hepatol
August 2025
Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
A recent study in examined the use of intravascular ultrasound (IVUS) for transjugular intrahepatic portosystemic shunt (TIPS) creation. The study concluded that IVUS significantly reduces procedure time, radiation exposure, and the number of needle passes compared to conventional fluoroscopic guidance. IVUS offers real-time visualization of the portal vein, but challenges remain in terms of equipment costs and the operator learning curve.
View Article and Find Full Text PDF