The transjugular intrahepatic portosystemic Stent-Shunt (TIPSS): Results of a pilot study

Goetz M. Richter, Gerd Noeldge, Julio C. Palmaz, Martin Roessle

Research output: Contribution to journalArticlepeer-review

132 Scopus citations

Abstract

The new concept of TIPSS (Transjugular Intrahepatic Portosystemic Stent-Shunt) using the Palmaz iliac stent was successfully accomplished in 9 patients with severe portal hypertension (7 alcoholic, 2 postinfectious liver cirrhosis) and histories of multiple life-threatening upper GI bleeding. All patients were considered noncandidates for surgical portal decompression. An intrahepatic central connection was made transjugularly between the right hepatic vein and the right portal vein in 8 patients and the left portal vein in 1. The portosystemic gradient dropped from an average of 29±7.2 mmHg to 17.8±2.9 mmHg immediately after, and to 15.7±2.8 mmHg at the latest follow-up control after the procedure. Seven patients survived the procedure and progressed to Child's A stage during the observation period of 1-10 months (mean 5 months). One patient died as a direct complication from the procedure, and another patient 11 days after the procedure from a severe nosocomial infection. In none of the surviving patients has bleeding from varices recurred or encephalopathic coma developed. In one patient the shunt diameter was moderately increased by a routine PTA catheter to further decrease the portosystemic gradient (23 to 14 mmHg) 3 months after the primary procedure. Autopsy in the two patients who died demonstrated open stent-shunts with early neoendothelial incorporation.

Original languageEnglish (US)
Pages (from-to)200-207
Number of pages8
JournalCardiovascular and Interventional Radiology
Volume13
Issue number3
DOIs
StatePublished - May 1 1990

Keywords

  • Gastrointestinal bleeding
  • Hypertension, portal, interventional treatment
  • Liver cirrhosis
  • Portosystemic shunt
  • Stents, vascular

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'The transjugular intrahepatic portosystemic Stent-Shunt (TIPSS): Results of a pilot study'. Together they form a unique fingerprint.

Cite this