{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:17:49Z","timestamp":1789021069535,"version":"build-2803163510"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":6028,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1999,3]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>The aim of this prospective, nonrandomized study was to assess the short\u2013 and long\u2013term effects of transjugular intrahepatic portosystemic shunt (TIPS) on hepatic and systemic hemodynamics and on gastroesophageal collateral flow in patients with cirrhosis and failure of chronic sclerotherapy. Cardiac output (CO), free and wedged pulmonary artery pressure (FPAP and WPAP) systemic vascular resistance (SVR) azygos venous blood flow (AzVBF), and the relative (portal minus vena cava) pressure in the portal vein (rel.PP) were determined immediately before, 30 minutes, 1 week, 3 months, and 1 year after TIPS implantation in 21 patients with alcoholic and biliary cirrhosis with repeated bleeding from esophageal varices despite chronic sclerotherapy. TIPS was inserted when patients were in a stable hemodynamic condition. Palmaz stents were dilated to a 10\u2013mm to 14\u2013mm diameter until gastroesophageal collaterals were no longer visible on direct splenoportography. Relative portal pressure decreased from 21 \u00b1 5 mm Hg to 11 \u00b1 5 mm Hg 30 minutes after the procedure (<jats:italic toggle=\"yes\">P<\/jats:italic>&lt; .001). CO increased from 7.1 \u00b1 1.5 L\/min at baseline to 8.9 \u00b1 2.0 L\/min (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; .005) at 30 minutes, 8.2 \u00b1 2.0 L\/min (<jats:italic toggle=\"yes\">P<\/jats:italic>&lt; .01) at 1 week, and 8.0 \u00b1 2.0 L\/min (<jats:italic toggle=\"yes\">P<\/jats:italic>&lt; .01) at 3 months after TIPS, and returned to 7.2 \u00b1 1.3 L\/min (ns) after 1 year. Before TIPS, SVR was 990 \u00b1 285 dyne \u00b7 sec \u00b7 cm<jats:sup>-5<\/jats:sup> and decreased to 856 \u00b1 252 dyne \u00b7 sec \u00b7 cm<jats:sup>-5<\/jats:sup> (<jats:italic toggle=\"yes\">P<\/jats:italic>&lt; .05) and 866 \u00b1 267 dyne \u00b7 sec \u00b7 cm<jats:sup>-5<\/jats:sup>\n                                 <jats:italic toggle=\"yes\">P<\/jats:italic>&lt; .05) at 30 minutes and 1 week after the procedure, and increased again to 903 \u00b1 208 dyne \u00b7 sec \u00b7 cm<jats:sup>-5<\/jats:sup> (s) and 1,016 \u00b1 260 dyne \u00b7 sec \u00b7 cm<jats:sup>-5<\/jats:sup> (ns) at 3 months and 1 year, respectively. AzVBF continuously decreased from 474 \u00b1 138 mL\/min before TIPS to 335 \u00b1 116 mL\/min, 289 \u00b1 147 mL\/min, 318 \u00b1 157 mL\/min, and 250 \u00b1 104 mL\/min (all <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; .005) at 30 minutes, 1 week, 3 months, and 1 year after TIPS. Portal decompression after TIPS is associated with a significant increase of CO for at least 3 months, which is only partly explained by a transient decrease of SVR. After 1 year, CO had returned to baseline levels. Despite an immediate decrease in portal pressure, the reduction of blood flow through gastroesophageal collaterals is delayed and not complete before 1 year after TIPS. In contrast to previous short\u2013term observations, TIPS does not seem to cause long\u2013term aggravation of the hyperkinetic circulation in patients with cirrhosis.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.510290302","type":"journal-article","created":{"date-parts":[[2004,7,28]],"date-time":"2004-07-28T07:25:38Z","timestamp":1090999538000},"page":"632-639","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":83,"title":["Transjugular Intrahepatic Portosystemic Shunt: Short\u2013Term and Long\u2013Term Effects on Hepatic and Systemic Hemodynamics in Patients With Cirrhosis"],"prefix":"10.1097","volume":"29","author":[{"given":"Erich","family":"Lotterer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Wengert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang E.","family":"Fleig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"BIB1","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1056\/NEJM199401203300303","volume":"330","author":"R\u00f6ssle","year":"1994","journal-title":"N Engl J Med"},{"key":"BIB2","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1148\/radiology.187.2.8475283","volume":"187","author":"LaBerge","year":"1993","journal-title":"Radiology"},{"key":"BIB3","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1148\/radiology.189.3.8234706","volume":"189","author":"Ferral","year":"1993","journal-title":"Radiology"},{"key":"BIB4","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1002\/hep.1840170125","volume":"17","author":"Conn","year":"1993","journal-title":"Hepatology"},{"key":"BIB5","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/S0168-8278(05)80454-4","volume":"17","author":"Groszmann","year":"1993","journal-title":"J Hepatol"},{"key":"BIB6","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1002\/hep.1840190121","volume":"19","author":"Azoulay","year":"1994","journal-title":"Hepatology"},{"key":"BIB7","doi-asserted-by":"crossref","first-page":"2121","DOI":"10.1007\/BF02208995","volume":"40","author":"Rodr\u00edguez-Laiz","year":"1995","journal-title":"Dig Dis Sci"},{"key":"BIB8","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1136\/gut.39.4.600","volume":"39","author":"Colombato","year":"1996","journal-title":"Gut"},{"key":"BIB9","first-page":"600","volume":"18","author":"Hadengue","journal-title":"J Hepatol"},{"key":"BIB10","first-page":"600","volume":"18","author":"Huonker","journal-title":"Hepatology"},{"key":"BIB11","first-page":"600","volume":"18","author":"Korula","journal-title":"Hepatology"},{"key":"BIB12","first-page":"600","volume":"18","author":"Le Moine","journal-title":"Hepatology"},{"key":"BIB13","first-page":"600","volume":"106","author":"van der Linden","journal-title":"Gastroenterology"},{"key":"BIB14","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1111\/j.1432-2277.1996.tb00899.x","volume":"9","author":"Antonini","year":"1996","journal-title":"Transpl Int"},{"key":"BIB15","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/S0168-8278(96)80065-1","volume":"25","author":"Lebrec","year":"1996","journal-title":"J Hepatol"},{"key":"BIB16","doi-asserted-by":"crossref","first-page":"816","DOI":"10.7326\/0003-4819-122-11-199506010-00002","volume":"122","author":"Wong","year":"1995","journal-title":"Ann Intern Med"},{"key":"BIB17","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1053\/gast.1997.v112.pm9041252","volume":"112","author":"Wong","year":"1997","journal-title":"Gastroenterology"},{"key":"BIB18","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1002\/bjs.1800600817","volume":"60","author":"Pugh","year":"1973","journal-title":"Br J Surg"},{"key":"BIB19","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1002\/hep.1840040312","volume":"4","author":"Bosch","year":"1984","journal-title":"Hepatology"},{"key":"BIB20","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1055\/s-2008-1040613","volume":"6","author":"Bosch","year":"1986","journal-title":"Semin Liver Dis"},{"key":"BIB21","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/S0016-5085(88)80024-6","volume":"95","author":"Zeeh","year":"1988","journal-title":"Gastroenterology"},{"key":"BIB22","first-page":"43","volume-title":"Endoscopic Control of Gastrointestinal Hemorrhage","author":"Paquet","year":"1981","unstructured":"Sclerotherapy of esophageal varices. 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