Transjugular intrahepatic portosystemic shunt (TIPS) as rescue therapy for endoscopic glue migration and bleeding gastric varices
Gastric variceal (GV) bleeding is an important and fatal complication for cirrhotic patients which has historically been controlled with sclerosants and band ligation. Cyanoacrylate glue therapy has emerged as a more favorable option with bleeding control of up to 90% and low complication rates; how...
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2021-08-01
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doaj-00830141529441ba921108d66f32b5382021-06-29T04:12:13ZengElsevierRadiology Case Reports1930-04332021-08-0116820352037Transjugular intrahepatic portosystemic shunt (TIPS) as rescue therapy for endoscopic glue migration and bleeding gastric varicesJenny Yan, MD0William Browne, MD1Andrew Kesselman, MD, RPVI2Corresponding Author.; Department of Vascular and Interventional Radiology, New York Presbyterian Hospital Weill Cornell Medicine, New York, NYDepartment of Vascular and Interventional Radiology, New York Presbyterian Hospital Weill Cornell Medicine, New York, NYDepartment of Vascular and Interventional Radiology, New York Presbyterian Hospital Weill Cornell Medicine, New York, NYGastric variceal (GV) bleeding is an important and fatal complication for cirrhotic patients which has historically been controlled with sclerosants and band ligation. Cyanoacrylate glue therapy has emerged as a more favorable option with bleeding control of up to 90% and low complication rates; however, several reports show possible ectopic systemic glue migration, most commonly into the portomesenteric system and leading to portal hypertension. To decompress portal pressures and mitigate future complications, transjugular intrahepatic portosystemic shunt (TIPS) placement may be a viable rescue therapy. We present two cases of TIPS placement for an 18-year-old and 51-year-old male in the setting of endoscopic glue migration into the portomesenteric system that demonstrate feasibility and success in temporizing acute variceal bleeding. Both cases demonstrated decompressing portovenous pressures but may result in need for re-intervention.http://www.sciencedirect.com/science/article/pii/S1930043321002971Variceal bleedCyanoacrylate glueTransjugular intrahepatic portosystemic shunt (TIPS) |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jenny Yan, MD William Browne, MD Andrew Kesselman, MD, RPVI |
spellingShingle |
Jenny Yan, MD William Browne, MD Andrew Kesselman, MD, RPVI Transjugular intrahepatic portosystemic shunt (TIPS) as rescue therapy for endoscopic glue migration and bleeding gastric varices Radiology Case Reports Variceal bleed Cyanoacrylate glue Transjugular intrahepatic portosystemic shunt (TIPS) |
author_facet |
Jenny Yan, MD William Browne, MD Andrew Kesselman, MD, RPVI |
author_sort |
Jenny Yan, MD |
title |
Transjugular intrahepatic portosystemic shunt (TIPS) as rescue therapy for endoscopic glue migration and bleeding gastric varices |
title_short |
Transjugular intrahepatic portosystemic shunt (TIPS) as rescue therapy for endoscopic glue migration and bleeding gastric varices |
title_full |
Transjugular intrahepatic portosystemic shunt (TIPS) as rescue therapy for endoscopic glue migration and bleeding gastric varices |
title_fullStr |
Transjugular intrahepatic portosystemic shunt (TIPS) as rescue therapy for endoscopic glue migration and bleeding gastric varices |
title_full_unstemmed |
Transjugular intrahepatic portosystemic shunt (TIPS) as rescue therapy for endoscopic glue migration and bleeding gastric varices |
title_sort |
transjugular intrahepatic portosystemic shunt (tips) as rescue therapy for endoscopic glue migration and bleeding gastric varices |
publisher |
Elsevier |
series |
Radiology Case Reports |
issn |
1930-0433 |
publishDate |
2021-08-01 |
description |
Gastric variceal (GV) bleeding is an important and fatal complication for cirrhotic patients which has historically been controlled with sclerosants and band ligation. Cyanoacrylate glue therapy has emerged as a more favorable option with bleeding control of up to 90% and low complication rates; however, several reports show possible ectopic systemic glue migration, most commonly into the portomesenteric system and leading to portal hypertension. To decompress portal pressures and mitigate future complications, transjugular intrahepatic portosystemic shunt (TIPS) placement may be a viable rescue therapy. We present two cases of TIPS placement for an 18-year-old and 51-year-old male in the setting of endoscopic glue migration into the portomesenteric system that demonstrate feasibility and success in temporizing acute variceal bleeding. Both cases demonstrated decompressing portovenous pressures but may result in need for re-intervention. |
topic |
Variceal bleed Cyanoacrylate glue Transjugular intrahepatic portosystemic shunt (TIPS) |
url |
http://www.sciencedirect.com/science/article/pii/S1930043321002971 |
work_keys_str_mv |
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