Transjugular intrahepatic portosystemic shunt (TIPS) is a well-established procedure used in the management of complications of portal hypertension. Although the most robust evidence supports the use of TIPS as salvage therapy in variceal hemorrhage, secondary prophylaxis of variceal bleeding, and treatment of refractory ascites, there is also data to suggest its efficacy in other indications such as hepatic hydrothorax, hepatorenal syndrome, and Budd-Chiari syndrome. Recent literature also suggests that TIPS may improve survival for certain subpopulations if placed early after variceal bleeding. This article provides an updated evidence-based review of the indications for TIPS. Outcomes, complications, and adequate patient selection are also discussed.
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| http://dx.doi.org/10.1016/j.cld.2019.07.004 | DOI Listing |
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Article Synopsis
- TIPS surgery is common for treating portal hypertension, impacting postoperative complications tied to the portal venous system's hemodynamics.
- The study utilizes computational modeling to evaluate hemodynamic outcomes based on varying shunt positions and geometrical simplification strategies, using clinical data from two patients.
- Results indicated that placing the shunt at the main portal vein is preferable for reducing postoperative portal pressure and wall shear stress, while underscoring the importance of model simplifications in simulations.
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