Selection of a TIPS stent for management of portal hypertension in liver cirrhosis: An evidence-base

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:lanaya0903
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
Nowadays,transjugular intrahepatic portosystemic shunt(TIPS)has become a mainstay treatment option for the management of portal hypertension-related complications in liver cirrhosis.Accumulated evidence has shown that its indications are being gradually expanded.Notwithstanding,less attention has been paid for the selection of an appropriate stent during a TIPS procedure.Herein,we attempt to review the current evidence regarding the diameter,type,brand,and position of TIPS stents.Several following recommendations may be considered in the clinical practice:(1)a 10-mm stent may be more effective than an 8-mm stent for the management of portal hypertension,and may be superior to a 12-mm stent for the improvement of survival and shunt patency;(2)covered stents are superior to bare stents for reducing the development of shunt dysfunction;(3)if available,Viatorr stent-grafts may be recommended due to a higher rate of shunt patency;and(4)the placement of a TIPS stent in the left portal vein branch may be more reasonable for decreasingthe development of hepatic encephalopathy.However,given relatively low quality of evidence,prospective well-designed studies should be warranted to further confirm these recommendations. Nowadays, transjugular intrahepatic portosystemic shunt (TIPS) has become a mainstay treatment option for the management of portal hypertension-related complications in liver cirrhosis. Accumulated evidence has shown that its indications are being gradually expanded. Nototstanding, less attention has been paid for the selection of an appropriate stent during a TIPS procedure. Herein, we attempt to review the current evidence regarding the diameter, type, brand, and position of TIPS stents. Several following recommendations may be considered in the clinical practice: (1) a 10-mm stent may be more effective than an 8-mm stent for the management of portal hypertension, and may be superior to a 12-mm stent for the improvement of survival and shunt patency; (2) covered stents are superior to bare stents for reducing the (3) if available, Viatorr stent-grafts may be recommended due to a higher rate of shunt patency; and (4) the placement of a TIPS stent in the left portal vein b ranch may be more reasonable for decreased the development of hepatic encephalopathy. However, given relatively low quality of evidence, prospective well-designed studies should be warranted to further confirm these recommendations.
其他文献
斯坦福大学正努力建立它的第一个“无书图书馆”。过去几十年的学术资料被一箱箱打包起来,从两座古老的图书馆———物理馆和工程馆———清空,为了给未来更小、但是更有效的
目的了解2006~2011年凉山州吸毒哨点人群中HIV-1新发感染情况。方法对2006、2008、2009、2010、2011年在吸毒哨点人群中采集的4103份有效样本,进行HIV检测,初筛阳性的样本经免
对国内外13家E-print系统进行实时调查,从用户使用网站过程的角度分析其网站服务功能,包括注册前的阅读浏览功能、注册功能、注册后的发文功能、信息服务功能、信息组织功能
战略规划是战略管理的重要内容之一,是组织应对环境变化、掌控未来、获取生存与发展的有力工具与手段。实践证明战略规划不仅适用于营利性组织,也有助于非营利性组织的发展。
质量是数据库建设的核心。本文从数据库建设的实践出发,探讨了从标准化、规范化,严格建设中的工作程序,强化检索功能,加强日常性维护,增强建设人员的教育培训等五个方面加强
Objective To investigate the prevalence of metabolic syndrome(MS) and its associations with other metabolic disorders and cardiovascular changes in health exami
胎儿神经系统发育畸形是最常见的胎儿先天异常,超声成像是产前发现胎儿脑畸形的常用诊断方法。侧脑室作为产前超声发现脑发育畸形的敏感线索,被广泛应用于产前检查中,是超声
目的探讨艾滋病患者中卡氏肺孢菌性肺炎的临床特征、诊断方法及治疗预防措施。方法对36例艾滋病患者合并卡氏肺孢菌性肺炎病例资料进行回顾性描述和分析。结果艾滋病患者CD4+
买了房子后接下来面临的就是装修和购买家具的问题了。怎样才能让装修和家具摆设体现自己的个人特色?如何精打细算用小钱办大事?下面从买房到装修,介绍几个非常实用的网站供你参考。    美家达人帮你在线设计  有了方案参考后,就要开始自己的家庭装修的设计了。大型专业的设计软件一般人很难上手,其实通过美家达人网在线设计,就算是家装设计小菜鸟,也可以快速设计出风格独特的家装方案。  http://www.me
忽略性横位是造成母婴死亡的最主要的难产类型之一,良好的孕期管理和适当的产时处理是解决由于忽略性横位所产生的不良妊娠结局的关键。文章对孕期如何防止忽略性横位的产生,