经脐静脉BRTOTIPS对BRTO的保护价值
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TIPS对BRTO保护价值

时间:2017-11-18 23:23来源:未知 作者:Mr.Editor 点击:
背景 TIPS is the primary IR therapy worldwide for both refractory ascites/hydrothorax and gastroesophageal variceal bleeding in the setting of portal hypertension BRTO has become more widely accepted as a therapy for gastric variceal bleed
背景
 
 TIPS is the primary IR therapy worldwide for both refractory ascites/hydrothorax and gastroesophageal variceal bleeding in the setting of portal hypertension

 BRTO has become more widely accepted as a therapy for gastric variceal bleeding as well as for treatment of hepatic encephalopathy in the setting of large portosystemic shunts.

 Major side effects associated with BRTO long term are the same symptoms often treated with TIPS
 
      Up to 2.6% will result in refractory ascites
      Up to 5.8% will result in refractory hepatichydrothorax
 
 Progressive esophageal varices
 
 No data exists to evaluate the effect of the combination of BRTO and TIPS together on the most common indication for TIPS in the US, refractory ascites/hydrothorax


病人分组基线数据(Patient Demographics)
 



BRTO做TIPS的适应症(Indications for TIPS with BRTO


Comp-Shunt: Spontaneous porto-systemic shunt competing with the TIPS
* BRTO performed after TIPS failed to decompress the gastric varices
**Zero time lapse since both the TIPS and the BRTO were performed within the same procedural setting.



结果(Results)






结果


(Ascites and Hydrothorax Free Rate in BRTO vs. BRTO + TIPS)








Kaplan-Meier Transudative Complication-Free Survival


Conclusion
 
 TIPS has a protective value for preventing &/or improving transudative complications associated with BRTO
 More studies are required to:
 validate this study
 evaluate the safety / survival of combined

TIPS+BRTO
 
 stratify
       TIPS pre-BRTO vs. BRTO pre-TIPS
       TIPS p   reformed concomitantly with BRTO
(责任编辑:Mr.Editor)
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