Emergent Transjugular Intrahepatic Portosystemic Shunt Creation for Acute Gastric Variceal Bleeding in Patients with Hepatocellular Carcinoma

作者：Zhang, Xiaowu; Tsauo, Jiaywei; Tie, Jun; Xue, Hui; Zhao, Jian-Bo; Li, Jian-Jun; Fang, Zhu-Ting; Guo, Wu-Hua; Li, Xiao^*

来源：Journal of Vascular and Interventional Radiology, 2022, 33(6): 702-706.

DOI：10.1016/j.jvir.2022.03.012

• PORTAL-HYPERTENSION
• CLASSIFICATION
• PREVALENCE
• MANAGEMENT
• TIPSS

A total of 42 cirrhotic patients (mean age, 51.7 years +/- 10.8; 38 men) with hepatocellular carcinoma who underwent emergent transjugular intrahepatic portosystemic shunt (TIPS) creation for controlling acute gastric variceal bleeding (GVB) were included in this multicenter retrospective study. Of these, 37 (88.1%) patients underwent emergent TIPS creation as the first-line treatment to control acute GVB. Five (11.9%) patients underwent emergent TIPS creation as a rescue/salvage treatment to control acute GVB after emergent endoscopic therapy and pharmacotherapy. Emergent TIPS creation was technically successful in 40 (95.2%) patients. Two (4.8%) patients had severe and moderate procedural adverse events. The median follow-up duration was 16.9 months (range, 0.1-100.8 months). Failure to control acute bleeding and failure to prevent rebleeding occurred in 8 (19.0%) patients during follow-up. Eighteen (42.9%) patients died during follow-up. Three (7.1%) patients had shunt dysfunction during follow-up. Overt hepatic encephalopathy occurred in 6 (14.3%) patients during follow-up.

• 单位
  中国医学科学院北京协和医院; 1; 南方医科大学; 西安交通大学