Intestinal varices: treatment with the transjugular intrahepatic portosystemic shunt

Radiology. 1994 Apr;191(1):183-7. doi: 10.1148/radiology.191.1.8134568.

Abstract

Purpose: To perform a retrospective evaluation of transjugular intrahepatic portosystemic shunt (TIPS) placement for treatment of intestinal varices.

Materials and methods: TIPS were placed in nine patients (six women and three men, aged 36-85 years [mean, 64 years]) with small- (n = 6) and large- (n = 3) intestinal varices. Six patients were actively bleeding at the time of shunt placement. One patient with colon cancer underwent prophylactic TIPS placement for variceal decompression before colectomy.

Results: The mean preprocedure portosystemic gradient of 26.8 mm Hg +/- 5.1 was reduced to 8.8 mm Hg +/- 2.9. Bleeding was controlled in all but one case, in which supplemental variceal embolization was required. Two patients died within 5 days of TIPS placement of preexisting multisystem failure. Three patients died of unrelated causes at 2, 6, and 7 months. The remaining patients were alive an average of 15 months after TIPS placement. There was no recurrent bleeding in any case.

Conclusion: TIPS placement is an effective method of decompressing intestinal varices.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Intestines / blood supply*
  • Liver Cirrhosis / complications
  • Male
  • Mesenteric Veins / diagnostic imaging
  • Middle Aged
  • Portasystemic Shunt, Surgical*
  • Radiography
  • Retrospective Studies
  • Stents
  • Varicose Veins / etiology
  • Varicose Veins / surgery*