Vnitr Lek 2023, 69(4):E16-E19 | DOI: 10.36290/vnl.2023.053

Transient hemodynamic instability caused by TIPS

David Schneider, Vladimír Kojecký
Interní oddělení, Krajská nemocnice Tomáše Bati ve Zlíně

Variceal bleeding belongs to the one of the complications of portal hypertension and is a life-threatening condition. A transjugular intrahepatic portosystemic shunt (TIPS) is indicated in case of failure of the pharmacological and endoscopic therapy, even if it is associated with complications. Stent migration to the heart, is a rare event which may cause perforation of the right cardiac chambers or damage to the tricuspid valve. However, it may not be a problem in some cases. There are two approaches to extraction - percutaneous or surgical. Leaving the stent in situ is possible, especially in polymorbid patients. Choosing an optimal approach often requires interdisciplinary cooperation.

Keywords: endoscopic ligation, oesophageal varices, portal hypertension, stent migration, TIPS, tricuspid regurgitation, variceal bleeding.

Accepted: June 19, 2023; Published: June 22, 2023  Show citation

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Schneider D, Kojecký V. Transient hemodynamic instability caused by TIPS. Vnitr Lek. 2023;69(4):E16-19. doi: 10.36290/vnl.2023.053.
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    References

    1. Fejfar T, Vaňásek T, Brůha R, et al. Léčba krvácení v důsledku portální hypertenze při jaterní cirhóze - aktualizace doporučených postupů ČHS ČLS JEP. Gastroent Hepatol. 2017; 71 (2): 105-16. [cit. 2023-01-17] Available from: WWW: . Go to original source...
    2. Arun J Sanyal, Jasmohan S Bajaj, Prediction of variceal hemorrhage in patients with cirrhosis. IN: Post TW (ed). UpToDate, Waltham, Massachusetts, 2022. [cit. 2023-01-18] Available from: WWW< https://www.uptodate.com/contents/prediction­‑of­‑variceal­‑hemorrhage­‑in­‑patients­‑with­‑cirrhosis?sectionName=PREDICTIVE%20FACTORS & search=variceal%20bleeding & topicRef=1254 & anchor=H129709535 & source=see_link#>.
    3. Petrasch F, Grothaus J, Mössner J, et al. Differences in bleeding behavior after endoscopic band ligation: a retrospective analysis. BMC Gastroenterol 2010; 10 (5).[cit. 2023-02-02] Available from: DOI Go to original source... Go to PubMed...
    4. Fejfar T, Jirkovský V, Šafka V. Transjugulární intrahepatální portosystémová spojka - 15 let v Hradci Králové: retrospektivní analýza 694 nemocných. Čes a Slov Gastroent a Hepatol. 2007;61(4):209-216 [cit. 2023-01-22] Available from: WWW
    5. Jirkovský V, Hůlek P, Fejfar T, et al. Dysfunkce transjugulární intrahepatální portosystémové spojky (TIPS) a její řešení. Vnitř Lék. 2007;53(2)157-163 [cit. 2023-01-31] Available from: WWW Go to PubMed...
    6. Mizrahi M, Adar T, Shouval D, et al. Endotipsitis­‑persistent infection of transjugular intrahepatic portosystemic shunt: pathogenesis, clinical features and management. Liver Int 2010;30(2):175-83. [cit. 2023-01-30] Available from: DOI Go to original source... Go to PubMed...
    7. Suhocki PV, Lungren MP, Kapoor B, et al. Transjugular intrahepatic portosystemic shunt complications: prevention and management. Semin Intervent Radiol. 2015;32(2):123-32.[cit. 2023-01-21] Available from: DOI Go to original source... Go to PubMed...
    8. Copelan A, Kapoor B, Sands M. Transjugular intrahepatic portosystemic shunt: indications, contraindications, and patient work­‑up. Semin Intervent Radiol. 2014;31(3):235-42. [cit. 2023-01-18] Available from: DOI . Go to original source... Go to PubMed...
    9. Ripamonti R, Ferral H, Alonzo M, et al. Transjugular intrahepatic portosystemic shunt­‑related complications and practical solutions. Semin Intervent Radiol. 2006;23(2):165-76. [cit. 2023-01-18] Available from: DOI Go to original source... Go to PubMed...
    10. Asehnoune K, Azoulay D, Andreani P, et al. [Cardiac perforation and tamponade during TIPS placement]. Ann Fr Anesth Reanim 2006;25(8):899-901. [cit. 2023-01-21] Available from: DOI Go to original source... Go to PubMed...
    11. Korrapati P, Bidari K, Komanduri S. Biliary Obstruction After Transjugular Intrahepatic Portosystemic Shunt Placement in a Patient With Budd­‑Chiari Syndrome. ACG Case Rep J 2015;2(2):101-3. [cit. 2023-01-22] Available from: DOI Go to original source... Go to PubMed...
    12. Kim E, Lee SW, Kim WH, et al. Transjugular Intrahepatic Portosystemic Shunt Occlusion Complicated with Biliary Fistula Successfully Treated with a Stent Graft: A Case Report. Iran J Radiol. 2016;13(1):e28993. [cit. 2023-01-22] Available from: DOI Go to original source... Go to PubMed...
    13. Madoff DC, Wallace MJ. Reduced stents and stent­‑grafts for the management of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt creation. Semin Intervent Radiol. 2005;22(4):316-28. [cit. 2023-01-22] Available from: DOI Go to original source... Go to PubMed...
    14. Liu GP, Zhang MY, Xu R, et al. Acute liver failure and infarction complicating TIPS placement. Radiol Case Rep 2019;14(7):876-9. [cit. 2023-01-22] Available from: DOI Go to original source...
    15. Wendler C, Shoenberger JM, Mailhot T, et al. Transjugular Intrahepatic Portosystemic Shunt (TIPS) Migration to the Heart Diagnosed by Emergency Department Ultrasound. West J Emerg Med 2012;13(6):525-6. [cit. 2023-01-19] Available from: DOI. Go to original source...
    16. Khalid MO, Moskovits N, Frankel RA, et al. Venous Stent Migrating to the Right Heart Causing Severe Regurgitation. J Investig Med High Impact Case Rep 2020;8:2324709620974220. [cit. 2023-01-19] Available from: . Go to original source...
    17. da Silva RF, Arroyo PC, Duca WJ Jr et al: Migration of transjugular intrahepatic portosystemic shunt to the right atrium: complications in the intraoperative period of liver transplantation Transplant Proc, 2008; 10: 3778-80. [cit. 2023-01-22] Available from: DOI< https://doi.org/10.1016/j.transproceed.2008. 06. 061> Go to original source...
    18. Fehervari I, Szonyi L, Fazakas J, et al. TIPS stent migration into the heart with 6-year follow­‑up. Ann Transplant 2011;16(2):109-12.[cit. 2023-01-22] Available from: DOI Go to original source... Go to PubMed...

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