title: Post-Transjugular Intrahepatic Portosystemic Shunt Follow-Up and Management in the VIATORR Era.
abstract: The transjugular intrahepatic portosystemic shunt (TIPS) is a non-selective portosystemic shunt created using endovascular techniques. The first TIPS was performed in Germany in 1988. The VIATORR self-expandable PTFE covered stent-graft (WL Gore, Flagstaff AZ) was approved by the FDA for a TIPS application in December of 2004. This stent-graft offers excellent shunt patency rates and it is possible that it has a beneficial effect on patient survival. Patient surveillance and post-procedural management have changed after the introduction of this stent-graft. This article presents the current management strategies that are followed at our Institution for patients who have undergone a TIPS procedure with a VIATORR stent graft including imaging follow-up, management of encephalopathy, medical management and nutritional aspects.
authors.affiliation: The Department of Radiology, Section of Interventional Radiology, NorthShore University HealthSystem, Evanston, IL. Electronic address: hectorferral@gmail.com.
authors.forename: Hector
authors.initials: H
authors.lastname: Ferral
authors.affiliation: Departamento de Gastroenterologia, Instituto Nacional de la Nutricion Salvador Zubiran, Tlalpan, Mexico City, Mexico.
authors.forename: Elisa
authors.initials: E
authors.lastname: Gomez-Reyes
authors.affiliation: University of Chicago Pritzker School of Medicine, Section Chief of Hepatology, Division of Gastroenterology, NorthShore University HealthSystem, Evanston, IL.
authors.forename: Claus J
authors.initials: CJ
authors.lastname: Fimmel
mesh_terms: D015901:Angiography, Digital Subtraction; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D009752:Nutritional Status; D010690:Phlebography; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D011172:Portography; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014654:Vascular Patency
keywords: encephalopathy; portosystemic shunt; stent-grafts; transhepatic; transjugular