Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic, Institut de Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain; Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, PR China.
Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic, Institut de Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain; Department of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, PR China.
Dig Liver Dis. 2024 Dec;56(12):1980-1988. doi: 10.1016/j.dld.2024.05.018. Epub 2024 Jun 8.
Transjugular intrahepatic portosystemic shunt (TIPS), a highly effective procedure reducing portal hypertension, has been in use for over seven decades and is now a cornerstone in managing portal hypertension-related complications such as variceal bleeding and ascites. Historically, TIPS has dealt with two main challenges: ensuring stent patency and preventing post-TIPS hepatic encephalopathy. The introduction of PTFE-coated stents markedly reduced the risk of TIPS dysfunction and stent patency is no longer a major concern. However, despite improved patient selection criteria, hepatic encephalopathy continues to be a significant and persistent issue. In addition, the broader application of TIPS in recent decades has brought to light additional, albeit less common, complications, such as post-TIPS heart failure. This review offers a comprehensive overview of TIPS historical evolution, advancements in technique, and its application in the treatment of portal hypertension.
经颈静脉肝内门体分流术（TIPS）是一种非常有效的降低门静脉高压的方法，已经应用了七十多年，现在是治疗门静脉高压相关并发症（如静脉曲张出血和腹水）的基石。从历史上看，TIPS 面临两个主要挑战：确保支架通畅和预防 TIPS 后肝性脑病。聚四氟乙烯（PTFE）涂层支架的引入显著降低了 TIPS 功能障碍的风险，支架通畅不再是主要问题。然而，尽管患者选择标准有所改善，但肝性脑病仍然是一个重要且持续存在的问题。此外，近年来 TIPS 的更广泛应用揭示了其他一些不太常见但同样重要的并发症，如 TIPS 后心力衰竭。本文综述了 TIPS 的历史演变、技术进展及其在门静脉高压治疗中的应用。
