Assessment of Clinical Outcomes, Clinical Manifestations, and Risk Factors for Hepatic Infarction After Transjugular Intrahepatic Portosystemic Shunt Placement (TIPS): A Retrospective Comparative Study

Purpose To describe the imaging findings of hepatic infarction after transjugular intrahepatic portosystemic shunt (TIPS) placement and identify risk factors, clinical manifestations, and outcomes of infarction after TIPS. Materials and Methods In this retrospective analysis of a TIPS registry (1995...

Full description

Saved in:
Bibliographic Details
Published in:Cardiovascular and interventional radiology 2022-10, Vol.45 (10), p.1512-1523
Main Authors: Tuifua, Tisileli S., Partovi, Sasan, Remer, Erick M., Ragheb, Jonathan, Bullen, Jennifer A., Kattan, Michael W., Kapoor, Baljendra
Format: Article
Language:English
Subjects:
Alanine
Alanine transaminase
Aspartate aminotransferase
Cardiology
Clinical Investigation
Comparative studies
Complications
Hazard assessment
Hazard identification
Hemoglobin
Hepatic artery
Imaging
Infarction
Liver diseases
Medicine
Medicine & Public Health
Nuclear Medicine
Patients
Placement
Portal vein
Radiology
Risk analysis
Risk factors
Segments
Thromboembolism
Thrombosis
TIPS
Transaminases
Ultrasound
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose To describe the imaging findings of hepatic infarction after transjugular intrahepatic portosystemic shunt (TIPS) placement and identify risk factors, clinical manifestations, and outcomes of infarction after TIPS. Materials and Methods In this retrospective analysis of a TIPS registry (1995–2021), cirrhotic patients with hepatic infarction ( n  = 33) and control patients without infarct ( n  = 33) after TIPS were identified. Laboratory values, ultrasound findings, and clinical variables were compared between groups to identify risk factors and differences in outcomes. A Cox proportional hazards regression model with propensity score was used to assess the effect of hepatic infarction on mortality and acute-on-chronic liver failure (ACLF) score. Results Hepatic infarction involved the right posterior segments (segments VI or VII) in 32 of 33 patients. Prolonged vasopressor requirement ( p  = 0.003) and intensive care unit stay ( p  = 0.001) were seen in patients with hepatic infarct, as well as trends toward lower post-TIPS portosystemic pressure gradient ( p  = 0.061) and higher risk of ACLF ( p  = 0.056). Procedure-related portal vein thrombosis or hepatic artery injury was identified in 12 and 5 patients with infarct, respectively. Patients with infarct had higher postprocedural aspartate aminotransferase ( p  
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-022-03219-7