Transjugular intrahepatic portosystemic shunts through hepatic neoplasms.
Transjugular intrahepatic portosystemic shunts (TIPS) were successfully placed through hepatic malignancy, without technical complication, in nine patients. A mean follow-up of 229 days (range, 53-391 days) was available in six patients. Ascites improved in three patients and variceal hemorrhage did not recur in another three patients. Hepatic encephalopathy occurred in three patients. Three acute shunt occlusions and two deaths occurred within 30 days of TIPS placement. Shunts that traverse malignancy can be created safely without increased technical complication. Although there is a high rate of acute shunt occlusion, hepatic neoplasm alone should not be a contraindication for TIPS placement.
Wallace
Michael
M
Section of Vascular and Interventional Radiology, Department of Diagnostic Radiology, the University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 325, Houston, Texas 77030-4009, USA. m.wallace@di.mdacc.tmc.edu
Swaim
Mark
M
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000601:surgery; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D016019:Survival Analysis; D013781:Texas; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D019043:Vascular Neoplasms / Q000473:pathology / Q000601:surgery