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经颈静脉肝内门体分流术的CIRSE实践标准。

CIRSE Standards of Practice on Transjugular Intrahepatic Portosystemic Shunts.

作者信息

Lucatelli Pierleone, Krajina Antonín, Loffroy Romaric, Miraglia Roberto, Pieper Claus Christian, Franchi-Abella Stéphanie, Rocco Bianca

机构信息

Department of Diagnostic Medicine and Radiology, Interventional Radiology Unit, Azienda Policlinico Universitario Policlinico Umberto I, Rome, Italy.

Department of Radiology, University Hospital, Charles University, Faculty of Medicine, Hradec Kralove, Czech Republic.

出版信息

Cardiovasc Intervent Radiol. 2024 Dec;47(12):1710-1726. doi: 10.1007/s00270-024-03866-y. Epub 2024 Nov 17.

Abstract

BACKGROUND

Proposed in the early 1980s as a solution for managing complications of portal hypertension, the percutaneous creation of transjugular intrahepatic portosystemic shunt has consistently gained a central role. Increasingly lower complication rates have been observed thanks to improvements in both technologies and the skills of interventional radiologists.

PURPOSE

This document is aimed at interventional radiologists and provides best practice recommendations for transjugular intrahepatic portosystemic shunt creation, describing patient selection, intraprocedural management and follow-up, in addition to recommendations in paediatric settings.

METHODS

The CIRSE Standards of Practice Committee established a writing group consisting of seven European clinicians with recognised expertise in the creation of transjugular intrahepatic portosystemic shunt. The writing group reviewed the existing literature performing a pragmatic evidence search using PubMed to select relevant publications in the English language and involving human subjects, preferably published from 2009 to 2024. The final recommendations were developed by consensus.

RESULTS

TIPS creation has an established role in the successful management of portal hypertension and its complications. This Standards of Practice document provides up-to-date recommendations for patient selection, materials, its safe performance, and follow-up with complications management.

摘要

背景

经颈静脉肝内门体分流术于20世纪80年代初被提出,作为处理门静脉高压并发症的一种解决方案,一直占据核心地位。由于技术和介入放射科医生技能的改进,观察到并发症发生率越来越低。

目的

本文针对介入放射科医生,提供经颈静脉肝内门体分流术创建的最佳实践建议,除了儿科环境中的建议外,还描述了患者选择、术中管理和随访。

方法

CIRSE实践标准委员会成立了一个写作小组,由七名在经颈静脉肝内门体分流术创建方面具有公认专业知识的欧洲临床医生组成。写作小组回顾了现有文献,使用PubMed进行务实的证据检索,以选择涉及人类受试者的英文相关出版物,最好是2009年至2024年发表的。最终建议通过共识制定。

结果

经颈静脉肝内门体分流术在门静脉高压及其并发症的成功管理中具有既定作用。本实践标准文件为患者选择、材料、安全操作以及并发症管理的随访提供了最新建议。

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