Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
National Clinical Research Center for Digestive Diseases, State Key Laboratory of Cancer Biology and Xijing Hospital of Digestive Diseases, Xijing Hospital, Air Force Military Medical University, Xi'an, Shaanxi, People's Republic of China.
J Vasc Interv Radiol. 2022 Jun;33(6):702-706. doi: 10.1016/j.jvir.2022.03.012.
A total of 42 cirrhotic patients (mean age, 51.7 years ± 10.8; 38 men) with hepatocellular carcinoma who underwent emergent transjugular intrahepatic portosystemic shunt (TIPS) creation for controlling acute gastric variceal bleeding (GVB) were included in this multicenter retrospective study. Of these, 37 (88.1%) patients underwent emergent TIPS creation as the first-line treatment to control acute GVB. Five (11.9%) patients underwent emergent TIPS creation as a rescue/salvage treatment to control acute GVB after emergent endoscopic therapy and pharmacotherapy. Emergent TIPS creation was technically successful in 40 (95.2%) patients. Two (4.8%) patients had severe and moderate procedural adverse events. The median follow-up duration was 16.9 months (range, 0.1-100.8 months). Failure to control acute bleeding and failure to prevent rebleeding occurred in 8 (19.0%) patients during follow-up. Eighteen (42.9%) patients died during follow-up. Three (7.1%) patients had shunt dysfunction during follow-up. Overt hepatic encephalopathy occurred in 6 (14.3%) patients during follow-up.
本多中心回顾性研究纳入了 42 例（平均年龄 51.7 ± 10.8 岁；38 名男性）因急性胃静脉曲张出血（GVB）而行紧急经颈静脉肝内门体分流术（TIPS）治疗的肝硬化患者。其中 37 例（88.1%）患者作为控制急性 GVB 的一线治疗方法接受紧急 TIPS 治疗。5 例（11.9%）患者作为紧急内镜治疗和药物治疗后控制急性 GVB 的紧急补救/挽救治疗方法接受紧急 TIPS 治疗。40 例（95.2%）患者紧急 TIPS 治疗技术上是成功的。2 例（4.8%）患者出现严重和中度程序不良事件。中位随访时间为 16.9 个月（范围 0.1-100.8 个月）。随访期间，8 例（19.0%）患者出现急性出血控制失败和再出血预防失败。18 例（42.9%）患者在随访期间死亡。3 例（7.1%）患者在随访期间发生分流功能障碍。6 例（14.3%）患者在随访期间出现显性肝性脑病。
