{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T18:35:00Z","timestamp":1775327700427,"version":"3.50.1"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":5783,"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":[[1999,11]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>The optimal management of ruptured gastric varices in patients with cirrhosis has not been codified yet. The present study reports the use of transjugular intrahepatic portosystemic shunt (TIPS) in patients with refractory gastric variceal bleeding. Thirty-two consecutive patients were included. All had been unresponsive to vasoactive agents infusion, sclerotherapy, and\/or tamponade and were considered poor surgical candidates. They were followed-up until death, transplantation, or at least 1 year (median: 509 days; range 4 to 2,230). Hemostasis was achieved in 18 out of 20 patients actively bleeding at the time of the procedure. In the whole sample of 32 patients, rebleeding rates were 14%, 26%, and 31%, respectively at 1 month, 6 months, and 1 year. <jats:italic toggle=\"yes\">De novo<\/jats:italic> encephalopathy was observed in 5 (16%) patients. Seven patients experienced complications and consequently 4 of these patients died. TIPS primary patency rates were 84%, 74%, and 51%, respectively, at 1 month, 6 months, and 1 year. For the same periods of time, survival rates were 75%, 62%, and 59%. These results suggest that TIPS can be used in cirrhotic patients with refractory gastric variceal bleeding and are effective in achieving hemostasis as well as in preventing rebleeding.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.510300523","type":"journal-article","created":{"date-parts":[[2004,7,28]],"date-time":"2004-07-28T07:40:08Z","timestamp":1091000408000},"page":"1139-1143","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":145,"title":["Transjugular intrahepatic portosystemic shunt in the treatment of refractory bleeding from ruptured gastric varices"],"prefix":"10.1097","volume":"30","author":[{"given":"Karl","family":"Barange","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Marie","family":"P\u00e9ron","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamran","family":"Imani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Otal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Louis","family":"Payen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herve","family":"Rousseau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Pierre","family":"Pascal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis","family":"Joffre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Pierre","family":"Vinel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"10.1002\/hep.510300523-BIB1|cit1","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1002\/hep.1840220145","article-title":"The treatment of portal hypertension: a meta-analytic review","volume":"22","author":"D'amico","year":"1995","journal-title":"Hepatology"},{"key":"10.1002\/hep.510300523-BIB2|cit2","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1056\/NEJM199505043321803","article-title":"The transjugular intrahepatic portosystemic stent-shunt procedure for refractory ascites","volume":"332","author":"Ochs","year":"1995","journal-title":"N Engl J Med"},{"key":"10.1002\/hep.510300523-BIB3|cit3","first-page":"A975","article-title":"Transjugular intrahepatic portosystemic shunt (TIPS) versus sclerotherapy for prevention of recurrent variceal hemorrhage: a randomized prospective trial [Abstract]","volume":"106","author":"Sanyal","year":"1994","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.510300523-BIB4|cit4","doi-asserted-by":"crossref","first-page":"297A","DOI":"10.1016\/0270-9139(95)94909-7","article-title":"TIPS versus sclerotherapy plus propranolol in the prevention of variceal rebleeding: preliminary results of a multicenter randomized trial [Abstract]","volume":"22","author":"Groupe d'\u00e9tude des anastomoses intra-h\u00e9patiques","year":"1995","journal-title":"Hepatology"},{"key":"10.1002\/hep.510300523-BIB5|cit5","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1053\/gast.1996.v110.pm8608893","article-title":"Transjugular intrahepatic portosystemic shunt versus sclerotherapy in the elective treatment of variceal hemorrhage","volume":"110","author":"Cabrera","year":"1996","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.510300523-BIB6|cit6","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1053\/gast.1997.v113.pm9352865","article-title":"Transjugular intrahepatic portosystemic stent shunt versus sclerotherapy plus propranolol for variceal bleeding","volume":"113","author":"Sauer","year":"1997","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.510300523-BIB7|cit7","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/S0140-6736(96)08189-5","article-title":"Randomised trial of transjugular intrahepatic portosystemic shunt versus endoscopy plus propranolol for prevention of variceal rebleeding","volume":"349","author":"R\u00f6ssle","year":"1997","journal-title":"Lancet"},{"key":"10.1002\/hep.510300523-BIB8|cit8","first-page":"1115","article-title":"A randomized trial comparing transjugular intrahepatic portosystemic stent-shunt with variceal band ligation in the prevention of rebleeding from esophageal varices","volume":"26","author":"Jalan","year":"1997","journal-title":"Hepatology"},{"key":"10.1002\/hep.510300523-BIB9|cit9","doi-asserted-by":"crossref","first-page":"858","DOI":"10.7326\/0003-4819-126-11-199706010-00002","article-title":"Endoscopic sclerotherapy compared with percutaneous transjugular intrahepatic portosystemic shunt after initial sclerotherapy in patients with acute variceal hemorrhage. 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