Khan Ayub, Bailey Christopher W
Medicine, West Virginia School of Osteopathic Medicine, Lewisburg, USA.
Interventional Radiology, Virginia Commonwealth University School of Medicine, Richmond, USA.
Cureus. 2021 Oct 17;13(10):e18838. doi: 10.7759/cureus.18838. eCollection 2021 Oct.
We report the case of a 27-year-old female patient with a history of cryptogenic cirrhosis who was admitted to the hospital due to multiple episodes of hematemesis secondary to bleeding esophageal varices. The varices were persistent and refractory to endoscopic intervention, so an emergent transjugular intrahepatic portosystemic shunt (TIPS) was performed by interventional radiology (IR). Months later, the patient returned to the hospital unresponsive with acute intermittent hepatic encephalopathy which required a TIPS reduction by IR. Once the TIPS reduction was performed, the patient's hepatic encephalopathy declined, and her symptoms improved. Here, we present a unique method of TIPS reduction utilizing a single Viabahn VBX balloon-expandable stent (W. L. Gore & Associates, Inc; Flagstaff, AZ) to constrain the existing TIPS stent.
我们报告了一例27岁的女性患者，该患者有隐源性肝硬化病史，因食管静脉曲张出血继发多次呕血入院。静脉曲张持续存在且对内镜干预无效，因此介入放射科（IR）进行了紧急经颈静脉肝内门体分流术（TIPS）。数月后，患者因急性间歇性肝性脑病无反应再次入院，需要介入放射科减少TIPS。一旦进行了TIPS减少，患者的肝性脑病症状减轻，症状得到改善。在此，我们介绍一种独特的TIPS减少方法，即使用单个Viabahn VBX球囊扩张支架（W.L.Gore & Associates, Inc；亚利桑那州弗拉格斯塔夫）来限制现有的TIPS支架。
