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Angiofibel pp 405–430Cite as

Transjugulärer intrahepatischer portosystemischer Stentshunt

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Zusammenfassung

Eine TIPSS(transjugulärer intrahepatischer portosystemischer Stentshunt)‑Anlage ist eine minimal-invasiv geschaffene Kurzschlussverbindung zwischen Pfortader und Lebervene und dient der partiellen Dekompression vor allem bei Symptomen der portalen Hypertension in Folge einer Leberzirrhose (beispielsweise Budd-Chiari-Syndrom-Behandlung aufgrund eines Verschlusses der Lebervenen). TIPSS (syn. TIPS) beschreibt die dauerhafte Offenhaltung des Parenchymtrakts durch die Leber mittels des Einsatzes von Endoprothesen [1], früher mittels Ballon- oder selbstexpandierenden Metallstents, heute meist unter Einsatz von selbstexpandierenden Stentgrafts. Die gemeinsame Indikationsstellung für einen TIPSS trifft in domo ein interdisziplinäres Leberboard besetzt mit Gastroenterologen, Transplantationsmedizinern, Chirurgen und Radiologen.

  • Leberzirrhose mit portaler Hypertension

  • rezidivierende Ösophagusvarizen (keine Erstblutung)

  • rezidivierende Fundusvarizenblutung (keine Erstblutung)

  • therapierefraktärer Aszites

  • Budd-Chiari-Syndrom (BCS)

Bei BCS immer eine heparininduzierte Thrombozytopenie (HIT)‑Diagnostik vor der TIPSS-Anlage durchführen, da in bis zu 30 % aller Fälle eines BCS eine begleitende HIT vorliegt. Bei deren Vorliegen ist diese Diagnose für alle am Eingriff Beteiligten unmissverständlich zu kommunizieren.

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Authors and Affiliations

  1. Radiologische Klinik, Abteilung Diagnostische und Interventionelle Radiologie, Universität Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    Boris A. Radeleff Prof. Dr.

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  1. Boris A. Radeleff Prof. Dr.
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Correspondence to Boris A. Radeleff Prof. Dr. .

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  1. Radiologische Klinik, Abteilung Diagnostische und Intervention, Universität Heidelberg, Im Neuenheimer Feld 110, Heidelberg, 69120, Baden-Württemberg, Germany

    Boris A. Radeleff

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Radeleff, B.A. (2013). Transjugulärer intrahepatischer portosystemischer Stentshunt. In: Radeleff, B. (eds) Angiofibel. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-33230-2_19

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  • DOI: https://doi.org/10.1007/978-3-642-33230-2_19

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-33229-6

  • Online ISBN: 978-3-642-33230-2

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