title: Transjugular intrahepatic porto-systemic shunt in the elderly: Palliation for complications of portal hypertension.
abstract: OBJECTIVE
  To present a dedicated series of transjugular intrahepatic porto-systemic shunts (TIPS) in the elderly since data is sparse on this population group.
  
  
  METHODS
  A retrospective review was performed of patients at least 65 years of age who underwent TIPS at our institutions between 1997 and 2010. Twenty-five patients were referred for TIPS. We deemed that 2 patients were not considered appropriate candidates due to their markedly advanced liver disease. Of the 23 patients suitable for TIPS, the indications for TIPS placement was portal hypertension complicated by refractory ascites alone (n = 9), hepatic hydrothorax alone (n = 2), refractory ascites and hydrothorax (n = 1), gastrointestinal bleeding alone (n = 8), gastrointestinal bleeding and ascites (n = 3).
  
  
  RESULTS
  Of these 23 attempted TIPS procedure patients, 21 patients had technically successful TIPS procedures. A total of 29 out of 32 TIPS procedures including revisions were successful in 21 patients with a mean age of 72.1 years (range 65-82 years). Three of the procedures were unsuccessful attempts at TIPS and 8 procedures were successful revisions of our existing TIPS. Sixteen of 21 patients who underwent successful TIPS (excluding 5 patients lost to follow-up) were followed for a mean of 14.7 mo. Ascites and/or hydrothorax was controlled following technically successful procedures in 12 of 13 patients. Bleeding was controlled following technically successful procedures in 10 out of 11 patients.
  
  
  CONCLUSIONS
  We have demonstrated that TIPS is an effective procedure to control refractory complications of portal hypertension in elderly patients.
authors.affiliation: Mubin I Syed, Azim Shaikh, Uzma Waheed, Kamal Morar, Robert Tyrrell, Dayton Interventional Radiology, Dayton, OH 45409, United States.
authors.forename: Mubin I
authors.initials: MI
authors.lastname: Syed
authors.forename: Hetal
authors.initials: H
authors.lastname: Karsan
authors.forename: Hector
authors.initials: H
authors.lastname: Ferral
authors.forename: Azim
authors.initials: A
authors.lastname: Shaikh
authors.forename: Uzma
authors.initials: U
authors.lastname: Waheed
authors.forename: Talal
authors.initials: T
authors.lastname: Akhter
authors.forename: Alan
authors.initials: A
authors.lastname: Gabbard
authors.forename: Kamal
authors.initials: K
authors.lastname: Morar
authors.forename: Robert
authors.initials: R
authors.lastname: Tyrrell