COMPLICATIONS OF TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT - A COMPREHENSIVE REVIEW
COMPLICATIONS OF TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT - A COMPREHENSIVE REVIEW
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DOI：
10.1148/radiographics.13.6.8290720
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发表时间：
1993-11-01
期刊：
影响因子：
5.5
通讯作者：
POSNER, MP
中科院分区：
文献类型：
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作者：
FREEDMAN, AM;SANYAL, AJ;POSNER, MP
经颈静脉肝内门体分流术（TIPS）的发病率和死亡率普遍低于外科分流术。然而，并发症发生了。作者回顾了他们的经验和其他机构在编制广泛的并发症列表。并发症根据与经皮穿刺、经静脉进入门静脉、门静脉插管、支架、穿刺部位、门体分流和造影剂相关的并发症进行分类。排除肝性脑病和分流管延迟性狭窄或闭塞，TIPS的总体并发症发生率预计低于10%。脑病加重或新发病例的患病率为5%-35%，从长期来看，高达75%的分流管可能会发生狭窄或闭塞。直接手术死亡率低于2%，30天死亡率范围为4%至45%，具体取决于几个因素。TIPS的作用将受到预防复发性静脉曲张出血的长期成功率的影响。
it is generally accepted that the transjugular intrahepatic portosystemic shunt (TIPS) procedure has lower morbidity and mortality rates than those of surgical shunting. Nevertheless, complications occur. The authors have reviewed their experience and that of other institutions in compiling an extensive list of complications. Complications are categorized according to those related to transhepatic needle puncture, transvenous access to the portal vein, portal venous cannulation, the stent, the puncture site, portosystemic shunting, and contrast material. Excluding hepatic encephalopathy and delayed stenosis or occlusion of the shunt, an overall complication rate of less than 10% can be expected for TIPS. The prevalence of aggravated or new cases of encephalopathy is 5%-35%, and over the long term, up to 75% of shunts may undergo stenosis or occlusion. The direct procedural mortality rate is less than 2%, and the 30-day mortality rate ranges from 4% to 45%, depending on several factors. The role to which TIPS is relegated will be influenced by the long-term success rate in the prevention of recurrent variceal hemorrhage.