Skip to main content
Gut logoLink to Gut
. 2000 Apr;46(4):578–581. doi: 10.1136/gut.46.4.578

TIPSS 10 years on

R JALAN 1, H LUI 1, D REDHEAD 1, P HAYES 1
PMCID: PMC1727896  PMID: 10716691

Full Text

The Full Text of this article is available as a PDF (107.2 KB).

Figure 1  .

Figure 1  

Role of transjugular intrahepatic portosystemic stent-shunts (TIPSS) in the management of variceal haemorrhage.

Figure 2  .

Figure 2  

Kaplan-Meier plots of proportion of patients free of shunt insufficiency during follow up with (assisted patency) and without (primary patency) intervention.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blum U., Rössle M., Haag K., Ochs A., Blum H. E., Hauenstein K. H., Astinet F., Langer M. Budd-Chiari syndrome: technical, hemodynamic, and clinical results of treatment with transjugular intrahepatic portosystemic shunt. Radiology. 1995 Dec;197(3):805–811. doi: 10.1148/radiology.197.3.7480760. [DOI] [PubMed] [Google Scholar]
  2. Burroughs A. K., Hamilton G., Phillips A., Mezzanotte G., McIntyre N., Hobbs K. E. A comparison of sclerotherapy with staple transection of the esophagus for the emergency control of bleeding from esophageal varices. N Engl J Med. 1989 Sep 28;321(13):857–862. doi: 10.1056/NEJM198909283211303. [DOI] [PubMed] [Google Scholar]
  3. Cabrera J., Maynar M., Granados R., Gorriz E., Reyes R., Pulido-Duque J. M., Rodriguez SanRoman J. L., Guerra C., Kravetz D. Transjugular intrahepatic portosystemic shunt versus sclerotherapy in the elective treatment of variceal hemorrhage. Gastroenterology. 1996 Mar;110(3):832–839. doi: 10.1053/gast.1996.v110.pm8608893. [DOI] [PubMed] [Google Scholar]
  4. Cello J. P., Ring E. J., Olcott E. W., Koch J., Gordon R., Sandhu J., Morgan D. R., Ostroff J. W., Rockey D. C., Bacchetti P. Endoscopic sclerotherapy compared with percutaneous transjugular intrahepatic portosystemic shunt after initial sclerotherapy in patients with acute variceal hemorrhage. A randomized, controlled trial. Ann Intern Med. 1997 Jun 1;126(11):858–865. doi: 10.7326/0003-4819-126-11-199706010-00002. [DOI] [PubMed] [Google Scholar]
  5. Chau T. N., Patch D., Chan Y. W., Nagral A., Dick R., Burroughs A. K. "Salvage" transjugular intrahepatic portosystemic shunts: gastric fundal compared with esophageal variceal bleeding. Gastroenterology. 1998 May;114(5):981–987. doi: 10.1016/s0016-5085(98)00640-4. [DOI] [PubMed] [Google Scholar]
  6. Coldwell D. M., Ring E. J., Rees C. R., Zemel G., Darcy M. D., Haskal Z. J., McKusick M. A., Greenfield A. J. Multicenter investigation of the role of transjugular intrahepatic portosystemic shunt in management of portal hypertension. Radiology. 1995 Aug;196(2):335–340. doi: 10.1148/radiology.196.2.7617842. [DOI] [PubMed] [Google Scholar]
  7. Crenshaw W. B., Gordon F. D., McEniff N. J., Perry L. J., Hartnell G., Anastopoulos H., Jenkins R. L., Lewis W. D., Wheeler H. G., Clouse M. E. Severe ascites: efficacy of the transjugular intrahepatic portosystemic shunt in treatment. Radiology. 1996 Jul;200(1):185–192. doi: 10.1148/radiology.200.1.8657908. [DOI] [PubMed] [Google Scholar]
  8. Forrest E. H., Stanley A. J., Redhead D. N., McGilchrist A. J., Hayes P. C. Clinical response after transjugular intrahepatic portosystemic stent shunt insertion for refractory ascites in cirrhosis. Aliment Pharmacol Ther. 1996 Oct;10(5):801–806. doi: 10.1046/j.1365-2036.1996.60202000.x. [DOI] [PubMed] [Google Scholar]
  9. García-Villarreal L., Martínez-Lagares F., Sierra A., Guevara C., Marrero J. M., Jiménez E., Monescillo A., Hernández-Cabrero T., Alonso J. M., Fuentes R. Transjugular intrahepatic portosystemic shunt versus endoscopic sclerotherapy for the prevention of variceal rebleeding after recent variceal hemorrhage. Hepatology. 1999 Jan;29(1):27–32. doi: 10.1002/hep.510290125. [DOI] [PubMed] [Google Scholar]
  10. Gordon F. D., Anastopoulos H. T., Crenshaw W., Gilchrist B., McEniff N., Falchuk K. R., LoCicero J., 3rd, Lewis W. D., Jenkins R. L., Trey C. The successful treatment of symptomatic, refractory hepatic hydrothorax with transjugular intrahepatic portosystemic shunt. Hepatology. 1997 Jun;25(6):1366–1369. doi: 10.1002/hep.510250611. [DOI] [PubMed] [Google Scholar]
  11. Grace N. D., Groszmann R. J., Garcia-Tsao G., Burroughs A. K., Pagliaro L., Makuch R. W., Bosch J., Stiegmann G. V., Henderson J. M., de Franchis R. Portal hypertension and variceal bleeding: an AASLD single topic symposium. Hepatology. 1998 Sep;28(3):868–880. doi: 10.1002/hep.510280339. [DOI] [PubMed] [Google Scholar]
  12. Guevara M., Ginès P., Bandi J. C., Gilabert R., Sort P., Jiménez W., Garcia-Pagan J. C., Bosch J., Arroyo V., Rodés J. Transjugular intrahepatic portosystemic shunt in hepatorenal syndrome: effects on renal function and vasoactive systems. Hepatology. 1998 Aug;28(2):416–422. doi: 10.1002/hep.510280219. [DOI] [PubMed] [Google Scholar]
  13. Guevara M., Ginès P., Fernández-Esparrach G., Sort P., Salmerón J. M., Jiménez W., Arroyo V., Rodés J. Reversibility of hepatorenal syndrome by prolonged administration of ornipressin and plasma volume expansion. Hepatology. 1998 Jan;27(1):35–41. doi: 10.1002/hep.510270107. [DOI] [PubMed] [Google Scholar]
  14. Haskal Z. J., Davis A., McAllister A., Furth E. E. PTFE-encapsulated endovascular stent-graft for transjugular intrahepatic portosystemic shunts: experimental evaluation. Radiology. 1997 Dec;205(3):682–688. doi: 10.1148/radiology.205.3.9393521. [DOI] [PubMed] [Google Scholar]
  15. Hirota S., Matsumoto S., Tomita M., Sako M., Kono M. Retrograde transvenous obliteration of gastric varices. Radiology. 1999 May;211(2):349–356. doi: 10.1148/radiology.211.2.r99ma25349. [DOI] [PubMed] [Google Scholar]
  16. Jalan R., Elton R. A., Redhead D. N., Finlayson N. D., Hayes P. C. Analysis of prognostic variables in the prediction of mortality, shunt failure, variceal rebleeding and encephalopathy following the transjugular intrahepatic portosystemic stent-shunt for variceal haemorrhage. J Hepatol. 1995 Aug;23(2):123–128. doi: 10.1016/0168-8278(95)80325-4. [DOI] [PubMed] [Google Scholar]
  17. Jalan R., Forrest E. H., Stanley A. J., Redhead D. N., Forbes J., Dillon J. F., MacGilchrist A. J., Finlayson N. D., Hayes P. C. A randomized trial comparing transjugular intrahepatic portosystemic stent-shunt with variceal band ligation in the prevention of rebleeding from esophageal varices. Hepatology. 1997 Nov;26(5):1115–1122. doi: 10.1002/hep.510260505. [DOI] [PubMed] [Google Scholar]
  18. Jalan R., John T. G., Redhead D. N., Garden O. J., Simpson K. J., Finlayson N. D., Hayes P. C. A comparative study of emergency transjugular intrahepatic portosystemic stent-shunt and esophageal transection in the management of uncontrolled variceal hemorrhage. Am J Gastroenterol. 1995 Nov;90(11):1932–1937. [PubMed] [Google Scholar]
  19. Jeffries M. A., Kazanjian S., Wilson M., Punch J., Fontana R. J. Transjugular intrahepatic portosystemic shunts and liver transplantation in patients with refractory hepatic hydrothorax. Liver Transpl Surg. 1998 Sep;4(5):416–423. doi: 10.1002/lt.500040506. [DOI] [PubMed] [Google Scholar]
  20. Lebrec D., Giuily N., Hadengue A., Vilgrain V., Moreau R., Poynard T., Gadano A., Lassen C., Benhamou J. P., Erlinger S. Transjugular intrahepatic portosystemic shunts: comparison with paracentesis in patients with cirrhosis and refractory ascites: a randomized trial. French Group of Clinicians and a Group of Biologists. J Hepatol. 1996 Aug;25(2):135–144. doi: 10.1016/s0168-8278(96)80065-1. [DOI] [PubMed] [Google Scholar]
  21. Lind C. D., Malisch T. W., Chong W. K., Richards W. O., Pinson C. W., Meranze S. G., Mazer M. Incidence of shunt occlusion or stenosis following transjugular intrahepatic portosystemic shunt placement. Gastroenterology. 1994 May;106(5):1277–1283. doi: 10.1016/0016-5085(94)90020-5. [DOI] [PubMed] [Google Scholar]
  22. Martin M., Zajko A. B., Orons P. D., Dodd G., Wright H., Colangelo J., Tartar R. Transjugular intrahepatic portosystemic shunt in the management of variceal bleeding: indications and clinical results. Surgery. 1993 Oct;114(4):719–727. [PubMed] [Google Scholar]
  23. McCormick P. A., Dick R., Panagou E. B., Chin J. K., Greenslade L., McIntyre N., Burroughs A. K. Emergency transjugular intrahepatic portasystemic stent shunting as salvage treatment for uncontrolled variceal bleeding. Br J Surg. 1994 Sep;81(9):1324–1327. doi: 10.1002/bjs.1800810922. [DOI] [PubMed] [Google Scholar]
  24. Merli M., Salerno F., Riggio O., de Franchis R., Fiaccadori F., Meddi P., Primignani M., Pedretti G., Maggi A., Capocaccia L. Transjugular intrahepatic portosystemic shunt versus endoscopic sclerotherapy for the prevention of variceal bleeding in cirrhosis: a randomized multicenter trial. Gruppo Italiano Studio TIPS (G.I.S.T.). Hepatology. 1998 Jan;27(1):48–53. doi: 10.1002/hep.510270109. [DOI] [PubMed] [Google Scholar]
  25. Nazarian G. K., Bjarnason H., Dietz C. A., Jr, Bernadas C. A., Foshager M. C., Ferral H., Hunter D. W. Refractory ascites: midterm results of treatment with a transjugular intrahepatic portosystemic shunt. Radiology. 1997 Oct;205(1):173–180. doi: 10.1148/radiology.205.1.9314981. [DOI] [PubMed] [Google Scholar]
  26. Ochs A., Rössle M., Haag K., Hauenstein K. H., Deibert P., Siegerstetter V., Huonker M., Langer M., Blum H. E. The transjugular intrahepatic portosystemic stent-shunt procedure for refractory ascites. N Engl J Med. 1995 May 4;332(18):1192–1197. doi: 10.1056/NEJM199505043321803. [DOI] [PubMed] [Google Scholar]
  27. Oho K., Iwao T., Sumino M., Toyonaga A., Tanikawa K. Ethanolamine oleate versus butyl cyanoacrylate for bleeding gastric varices: a nonrandomized study. Endoscopy. 1995 Jun;27(5):349–354. doi: 10.1055/s-2007-1005712. [DOI] [PubMed] [Google Scholar]
  28. Papatheodoridis G. V., Goulis J., Leandro G., Patch D., Burroughs A. K. Transjugular intrahepatic portosystemic shunt compared with endoscopic treatment for prevention of variceal rebleeding: A meta-analysis. Hepatology. 1999 Sep;30(3):612–622. doi: 10.1002/hep.510300316. [DOI] [PubMed] [Google Scholar]
  29. Rees C. J., Rose J. D., Record C. O., Day C. P., Bassendine M. F., James O. F., Hudson M. Transjugular intrahepatic portosystemic shunt: a limited role in refractory ascites. Eur J Gastroenterol Hepatol. 1997 Oct;9(10):969–973. doi: 10.1097/00042737-199710000-00009. [DOI] [PubMed] [Google Scholar]
  30. Rössle M., Deibert P., Haag K., Ochs A., Olschewski M., Siegerstetter V., Hauenstein K. H., Geiger R., Stiepak C., Keller W. Randomised trial of transjugular-intrahepatic-portosystemic shunt versus endoscopy plus propranolol for prevention of variceal rebleeding. Lancet. 1997 Apr 12;349(9058):1043–1049. doi: 10.1016/s0140-6736(96)08189-5. [DOI] [PubMed] [Google Scholar]
  31. Rössle M., Haag K., Ochs A., Sellinger M., Nöldge G., Perarnau J. M., Berger E., Blum U., Gabelmann A., Hauenstein K. The transjugular intrahepatic portosystemic stent-shunt procedure for variceal bleeding. N Engl J Med. 1994 Jan 20;330(3):165–171. doi: 10.1056/NEJM199401203300303. [DOI] [PubMed] [Google Scholar]
  32. Sanyal A. J., Freedman A. M., Luketic V. A., Purdum P. P., 3rd, Shiffman M. L., Cole P. E., Tisnado J., Simmons S. Transjugular intrahepatic portosystemic shunts compared with endoscopic sclerotherapy for the prevention of recurrent variceal hemorrhage. A randomized, controlled trial. Ann Intern Med. 1997 Jun 1;126(11):849–857. doi: 10.7326/0003-4819-126-11-199706010-00001. [DOI] [PubMed] [Google Scholar]
  33. Sanyal A. J., Freedman A. M., Luketic V. A., Purdum P. P., Shiffman M. L., Tisnado J., Cole P. E. Transjugular intrahepatic portosystemic shunts for patients with active variceal hemorrhage unresponsive to sclerotherapy. Gastroenterology. 1996 Jul;111(1):138–146. doi: 10.1053/gast.1996.v111.pm8698192. [DOI] [PubMed] [Google Scholar]
  34. Sanyal A. J., Freedman A. M., Shiffman M. L., Purdum P. P., 3rd, Luketic V. A., Cheatham A. K. Portosystemic encephalopathy after transjugular intrahepatic portosystemic shunt: results of a prospective controlled study. Hepatology. 1994 Jul;20(1 Pt 1):46–55. doi: 10.1016/0270-9139(94)90133-3. [DOI] [PubMed] [Google Scholar]
  35. Sarin S. K., Lamba G. S., Kumar M., Misra A., Murthy N. S. Comparison of endoscopic ligation and propranolol for the primary prevention of variceal bleeding. N Engl J Med. 1999 Apr 1;340(13):988–993. doi: 10.1056/NEJM199904013401302. [DOI] [PubMed] [Google Scholar]
  36. Sauer P., Theilmann L., Stremmel W., Benz C., Richter G. M., Stiehl A. Transjugular intrahepatic portosystemic stent shunt versus sclerotherapy plus propranolol for variceal rebleeding. Gastroenterology. 1997 Nov;113(5):1623–1631. doi: 10.1053/gast.1997.v113.pm9352865. [DOI] [PubMed] [Google Scholar]
  37. Somberg K. A., Riegler J. L., LaBerge J. M., Doherty-Simor M. M., Bachetti P., Roberts J. P., Lake J. R. Hepatic encephalopathy after transjugular intrahepatic portosystemic shunts: incidence and risk factors. Am J Gastroenterol. 1995 Apr;90(4):549–555. [PubMed] [Google Scholar]
  38. Stanley A. J., Jalan R., Ireland H. M., Redhead D. N., Bouchier I. A., Hayes P. C. A comparison between gastric and oesophageal variceal haemorrhage treated with transjugular intrahepatic portosystemic stent shunt (TIPSS). Aliment Pharmacol Ther. 1997 Feb;11(1):171–176. doi: 10.1046/j.1365-2036.1997.106277000.x. [DOI] [PubMed] [Google Scholar]
  39. Williams D. B., Waugh R., Selby W. Transjugular intrahepatic portosystemic shunt (TIPS) for the treatment of refractory ascites. Aust N Z J Med. 1998 Oct;28(5):620–626. doi: 10.1111/j.1445-5994.1998.tb00658.x. [DOI] [PubMed] [Google Scholar]
  40. Wong F., Sniderman K., Liu P., Allidina Y., Sherman M., Blendis L. Transjugular intrahepatic portosystemic stent shunt: effects on hemodynamics and sodium homeostasis in cirrhosis and refractory ascites. Ann Intern Med. 1995 Jun 1;122(11):816–822. doi: 10.7326/0003-4819-122-11-199506010-00002. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES