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Challenging cirrhosis: Why has TIPS become the new favorite for the treatment of portal hypertension?
Liver cirrhosis is a deadly condition that hides behind many diseases and poses significant health risks to patients. Portal hypertension, as a complication of cirrhosis, often leads to severe bleeding and ascites. Fortunately, with the advancement of medical technology, TIPS (transjugular intrahepatic portal system shunt) has become an innovative treatment option, providing patients with the key to life.
The basic principle of TIPS
A TIPS is an artificial channel that connects the portal vein inside the liver to the hepatic vein. This procedure is primarily performed by experienced interventional radiologists using an image-guided endovascular approach, often starting with the internal jugular vein. Its purpose is to address the portal hypertension caused by cirrhosis, which can not only reduce the risk of bleeding caused by esophageal varices, but also relieve ascites.
Historical BackgroundThe history of TIPS dates back to 1969, when Joseph Rosch first described the surgical technique at Oregon Health & Science University in the United States. The technology was first used on humans in 1982, and with the development of vascular stents in 1985, the success rate of TIPS also increased. In 1988, a research team from the University of Freiburg achieved the first successful TIPS, and since then this technology has quickly become the preferred method for treating portal hypertension.
Medical Applications
TIPS is considered a life-or-death option when patients have bleeding from esophageal or gastric varices. A randomized study showed that patients' survival rates were higher if the procedure was performed within 72 hours of the hemorrhage. In addition, TIPS has shown some potential for patients with hepatorenal syndrome and can combat the formation of ascites.
Potential complicationsAlthough the TIPS procedure is relatively safe, there are still certain risks. Under the operation of experienced doctors, the surgical mortality rate is less than 1%. However, approximately 25% of patients experience transient hepatic encephalopathy after surgery, which is caused by altered intestinal nitrogen flow. More serious complications include acute liver failure due to hepatic ischemia and persistent TIPS infection, which require careful monitoring and management.
The mechanism of TIPS
Portal hypertension is a potential health crisis, and TIPS works by reducing the effective vascular resistance of the liver. By creating a shunt from the portal vein to the hepatic vein, blood in the portal vein can be more efficiently drained into the systemic circulation, thereby reducing pressure in the portal vein. This process not only reduces gastrointestinal congestion pressure, but also reduces the possibility of future bleeding.
Execution process
TIPS is usually performed by an experienced interventional radiologist under fluoroscopic guidance. The procedure begins with your doctor gaining access to the vascular system through the internal jugular vein in the neck and through this route into the hepatic veins for manipulation. Using a special needle and dilatation balloon, doctors are able to create the necessary channel in the liver and insert a stent to keep it open.
Future Challenges and Prospects
Although TIPS technology has shown good results in treating cirrhosis and its induced portal hypertension, this medical solution still needs further research and improvement. The challenge for the future is to reduce the likelihood of complications and to continue to develop more advanced technologies to improve patients' quality of life.
The emergence of TIPS technology is like a breath of fresh air, bringing new hope to the lives of many patients.
With the continuous advancement of medicine, TIPS technology has become an important tool in combating cirrhosis and its complications. However, whether such a life-changing technology will become more popular as the technology matures, or even become the first choice for treating liver cirrhosis, is also a question worth pondering.
