Cabrera AT, Ramírez AJL

Idioma: Español
Referencias bibliográficas: 30
Paginas: 243-246
Archivo PDF: 67.39 Kb.

RESUMEN

En 1969, Rösch describió por primera vez la creación de una fístula transhepática entre el sistema de la vena porta y una de las venas suprahepáticas, pero no fue sino hasta los años 80 que comenzó su aplicación clínica. Los TIPS, conocidos así por sus siglas en inglés de Transjugular Intrahepatic Portosystemic Shunt, son desde hace 15 años una opción segura y efectiva del tratamiento de la hipertensión porta y sus complicaciones mayores que son el sangrado de várices y la ascitis. Sin embargo, sus mayores obstáculos han sido su alto índice de disfunción secundario a oclusión de la prótesis y su alta asociación con encefalopatía. Los TIPS están indicados por ser un tratamiento eficaz y poco invasivos en el sangrado primario de várices o recurrente sin respuesta al tratamiento médico y endoscópico en la ascitis refractaria a tratamiento farmacológico. Uno de los cambios de mayor importancia en la tecnología de los TIPS ha sido la creación de las prótesis cubiertas que tienen menor índice de re-epitelización y oclusión de la misma, por lo que este artículo trata de revisar los resultados hasta ahora publicados de las prótesis cubiertas y cómo han mejorado favorablemente la evolución de los pacientes tratados con estas endoprótesis.

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