{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T22:11:11Z","timestamp":1759702271067},"reference-count":18,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2004,6,16]],"date-time":"2004-06-16T00:00:00Z","timestamp":1087344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2004,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background and Aims:\u2002<\/jats:bold> The optimal management of acute Budd\u2013Chiari syndrome (BCS) with liver failure is controversial. Options include anticoagulation, portal systemic shunting or liver transplantation. In recent years, transjugular intrahepatic portosystemic shunts (TIPS) have been tried in place of shunt surgery. We report our experience with a policy of initial interventional radiological treatment (TIPS) in this patient group.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> A consecutive, non\u2010selected series of five patients with acute BCS with liver failure presenting to our liver unit over a 36\u2010month period from October 2000 were treated with a policy of initial attempt at transjugular shunt.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> Stents were successfully inserted in four patients. In one patient the hepatic vein remnant could not be cannulated. One of the four stented patients had a hepatic venous web. Rapid recurrent portal and hepatic vein thrombosis occurred in one patient despite anticoagulation and trans\u2010shunt thrombectomy. This patient and the patient with failed stenting underwent successful liver transplantation. One successfully stented patient died unexpectedly at home 2\u2003weeks after TIPS insertion. Four of five patients are alive (80%) at a mean follow\u2010up time of 30\u2003months.<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold> Initial TIPS, with liver transplantation for treatment failures, may be a reasonable, cost\u2010effective and surgery\u2010sparing treatment for acute Budd\u2013Chiari presenting with liver failure.<\/jats:p>","DOI":"10.1111\/j.1440-1746.2004.03427.x","type":"journal-article","created":{"date-parts":[[2004,12,27]],"date-time":"2004-12-27T07:27:58Z","timestamp":1104132478000},"page":"1135-1139","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Acute Budd\u2013Chiari syndrome with liver failure: The experience of a policy of initial interventional radiological treatment using transjugular intrahepatic portosystemic shunt"],"prefix":"10.1111","volume":"19","author":[{"given":"PAUL M","family":"KAVANAGH","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JAQUELINE","family":"ROBERTS","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ROBIN","family":"GIBNEY","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"DERMOT","family":"MALONE","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JOHN","family":"HEGARTY","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P AIDEN","family":"MCCORMICK","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2004,9,15]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510310307"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(05)80249-1"},{"key":"e_1_2_5_4_2","first-page":"2304","article-title":"Use of transjugular intrahepatic portosystemic shunt as a bridge to transplantation in fulminant liver failure from Budd\u2013Chiari syndrome","volume":"92","author":"Shrestha R","year":"1997","journal-title":"Am. 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