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The Role of Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Treating Portal Hypertension in Patients with Hepatocellular Carcinoma

التفاصيل البيبلوغرافية
العنوان: The Role of Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Treating Portal Hypertension in Patients with Hepatocellular Carcinoma
المؤلفون: Daniele Balducci, Michele Montori, Federico De Blasio, Alessandro Di Bucchianico, Maria Eva Argenziano, Gianluca Svegliati Baroni, Emidio Scarpellini
المصدر: Medicina, Vol 59, Iss 6, p 1150 (2023)
بيانات النشر: MDPI AG, 2023.
سنة النشر: 2023
المجموعة: LCC:Medicine (General)
مصطلحات موضوعية: transjugular intrahepatic portosystemic shunt, hepatocellular carcinoma, locoregional therapy, systemic therapy, liver surgery, Medicine (General), R5-920
الوصف: Liver cancer is very frequent, and hepatocellular carcinoma (HCC) accounts for the majority of liver cancer cases. Its growing incidence has been greatly affected by the increasing prevalence of metabolic-associated fatty liver disease (MAFLD). The latter is a new epidemic in our era. In fact, HCC is often generated from noncirrhotic liver and its treatment benefits from surgical and nonsurgical approaches, potentially bridged by transjugular intrahepatic portosystemic shunt (TIPS) use. TIPS use is an effective treatment for portal hypertension complications, but its application in patients with HCC and clinically significant portal hypertension (CSPH) remains controversial due to concerns about tumor rupture, dissemination, and increased toxicity. The technical feasibility and safety of TIPS use in HCC patients have been evaluated in several studies. Despite concerns about intraprocedural complications, retrospective studies have shown high success rates and low complication rates in TIPS placement for HCC patients. TIPS use in combination with locoregional treatments, such as transarterial chemoembolization (TACE) or transarterial radioembolization (TARE), has been explored as a treatment option for HCC patients with portal hypertension. These studies have shown improved survival rates in patients undergoing TIPS in combination with locoregional treatments. However, the efficacy and toxicity of TACE in combination with TIPS use require careful evaluation, as changes in venous and arterial flow can affect treatment outcomes and complications. The results from studies evaluating the impact of TIPS on systemic therapy and surgical options are also promising. In conclusion, the TIPS is a sufficiently safe, useful item available for physicians treating complications of portal hypertension. Moreover, a TIPS can be used in combination with locoregional therapy in HCC patients. Systemic chemotherapy can also benefit of the use of TIPS placement. A complex interplay affects TIPS use with surgery. The latter needs further data. The TIPS is a useful and safe add-on treatment, changing the natural course of HCC progression. Its use is regulated by a sophisticated physiologic and pathophysiologic flow of evidence.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 1648-9144
1010-660X
Relation: https://www.mdpi.com/1648-9144/59/6/1150; https://doaj.org/toc/1010-660X; https://doaj.org/toc/1648-9144
DOI: 10.3390/medicina59061150
URL الوصول: https://doaj.org/article/d6ea34e7a3ee47ea863f8e408d882883
رقم الأكسشن: edsdoj.6ea34e7a3ee47ea863f8e408d882883
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:16489144
1010660X
DOI:10.3390/medicina59061150