Refractory ascites

Early experience in treatment with transjugular intrahepatic portosystemic shunt

Hector Ferral, Haraldur Bjarnason, Scott A. Wegryn, Gail J. Rengel, Gwen K. Nazarian, Jeffrey M. Rank, S. Murthy Tadavarthy, David W. Hunter, Wilfrido R. Castaneda-Zuniga

Research output: Contribution to journalArticle

121 Citations (Scopus)

Abstract

PURPOSE: To evaluate the transjugular intrahepatic portosystemic shunt (TIPS) in treatment of refractory ascites. MATERIALS AND METHODS: Fourteen patients with chronic liver disease and portal hypertension were included in a prospective study. Six patients had Child-Pugh class B disease; eight had class C disease. Indications for TIPS were three previous hospital admissions over 9 months for treatment of tense ascites, no response to diuretic therapy, or an occluded peritoneovenous shunt with tense ascites. The volume of ascitic fluid was sonographically evaluated before and after TIPS placement. RESULTS: The technical success rate for TIPS creation was 93%. Mean portosystemic gradient decreased from 22.8 mm Hg ± 7.2 before TIPS placement to 11.3 mm Hg ± 3.6 after TIPS (P = .005). Complete resolution of ascites was achieved in seven (50%) patients. Treatment failed in seven; five had Child-Pugh class C disease, and four of these had a Child-Pugh score greater than 11. CONCLUSION: These results are comparable to those for other forms of treatment of ascites. The authors do not, however, recommend TIPS in patients with a Child-Pugh score greater than 11.

Original languageEnglish (US)
Pages (from-to)795-801
Number of pages7
JournalRadiology
Volume189
Issue number3
DOIs
StatePublished - Jan 1 1993

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Transjugular Intrahepatic Portasystemic Shunt
Ascites
Therapeutics
Peritoneovenous Shunt
Ascitic Fluid
Portal Hypertension
Diuretics
Liver Diseases
Chronic Disease
Prospective Studies

Keywords

  • Ascites, 791.77
  • Liver, cirrhosis, 761.794
  • Shunts, portosystemic, 761.453

Cite this

Ferral, H., Bjarnason, H., Wegryn, S. A., Rengel, G. J., Nazarian, G. K., Rank, J. M., ... Castaneda-Zuniga, W. R. (1993). Refractory ascites: Early experience in treatment with transjugular intrahepatic portosystemic shunt. Radiology, 189(3), 795-801. https://doi.org/10.1148/radiology.189.3.8234706

Refractory ascites : Early experience in treatment with transjugular intrahepatic portosystemic shunt. / Ferral, Hector; Bjarnason, Haraldur; Wegryn, Scott A.; Rengel, Gail J.; Nazarian, Gwen K.; Rank, Jeffrey M.; Tadavarthy, S. Murthy; Hunter, David W.; Castaneda-Zuniga, Wilfrido R.

In: Radiology, Vol. 189, No. 3, 01.01.1993, p. 795-801.

Research output: Contribution to journalArticle

Ferral, H, Bjarnason, H, Wegryn, SA, Rengel, GJ, Nazarian, GK, Rank, JM, Tadavarthy, SM, Hunter, DW & Castaneda-Zuniga, WR 1993, 'Refractory ascites: Early experience in treatment with transjugular intrahepatic portosystemic shunt', Radiology, vol. 189, no. 3, pp. 795-801. https://doi.org/10.1148/radiology.189.3.8234706
Ferral H, Bjarnason H, Wegryn SA, Rengel GJ, Nazarian GK, Rank JM et al. Refractory ascites: Early experience in treatment with transjugular intrahepatic portosystemic shunt. Radiology. 1993 Jan 1;189(3):795-801. https://doi.org/10.1148/radiology.189.3.8234706
Ferral, Hector ; Bjarnason, Haraldur ; Wegryn, Scott A. ; Rengel, Gail J. ; Nazarian, Gwen K. ; Rank, Jeffrey M. ; Tadavarthy, S. Murthy ; Hunter, David W. ; Castaneda-Zuniga, Wilfrido R. / Refractory ascites : Early experience in treatment with transjugular intrahepatic portosystemic shunt. In: Radiology. 1993 ; Vol. 189, No. 3. pp. 795-801.
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