Semin intervent Radiol 2019; 36(02): 072-075
DOI: 10.1055/s-0039-1688418
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hemolytic Anemia following Stent-Graft Transjugular Intrahepatic Portosystemic Shunt Creation

Andrew Kuei
1   Department of Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois
,
Adam E. Mikolajczyk
2   Division of Gastroenterology and Hepatology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois
,
Matthew M. Niemeyer
1   Department of Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois
3   Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois
› Author Affiliations
Further Information

Publication History

Publication Date:
22 May 2019 (online)

Abstract

Transjugular intrahepatic portosystemic shunt (TIPS) creation is a minimally invasive technique aimed at managing the complications of portal hypertension. Initially performed in the setting of variceal bleeding, the role of TIPS has expanded to treatment of medically refractory ascites, portal hypertensive gastropathy, hepatic hydrothorax, Budd-Chiari syndrome, portal vein thrombus, and hepatorenal syndrome. Potential complications from TIPS are well documented, and include hepatic encephalopathy, hepatic failure, and TIPS dysfunction. Hemolytic anemia is a lesser known complication related to TIPS creation. In this article, a case of hemolytic anemia following TIPS creation using a Viatorr stent-graft in described.

Disclosure

A.K., A.E.M., and M.M.N. have nothing to disclose.


 
  • References

  • 1 Richter GM, Palmaz JC, Nöldge G. , et al. [The transjugular intrahepatic portosystemic stent-shunt. A new nonsurgical percutaneous method]. Radiologe 1989; 29 (08) 406-411
  • 2 Yang Z, Han G, Wu Q. , et al. Patency and clinical outcomes of transjugular intrahepatic portosystemic shunt with polytetrafluoroethylene-covered stents versus bare stents: a meta-analysis. J Gastroenterol Hepatol 2010; 25 (11) 1718-1725
  • 3 Saad WE. The history and future of transjugular intrahepatic portosystemic shunt: food for thought. Semin Intervent Radiol 2014; 31 (03) 258-261
  • 4 Copelan A, Kapoor B, Sands M. Transjugular intrahepatic portosystemic shunt: indications, contraindications, and patient work-up. Semin Intervent Radiol 2014; 31 (03) 235-242
  • 5 Suhocki PV, Lungren MP, Kapoor B, Kim CY. Transjugular intrahepatic portosystemic shunt complications: prevention and management. Semin Intervent Radiol 2015; 32 (02) 123-132
  • 6 Sanyal AJ, Freedman AM, Purdum PP, Shiffman ML, Luketic VA. The hematologic consequences of transjugular intrahepatic portosystemic shunts. Hepatology 1996; 23 (01) 32-39
  • 7 Sanyal AJ, Freedman AM, Purdum III PP. TIPS-associated hemolysis and encephalopathy. Ann Intern Med 1992; 117 (05) 443-444
  • 8 Cheng KH, Laméris JS, de Man RA, Pieterman H, van Buuren HR. Haemolysis and cholestasis following implantation of a transjugular intrahepatic portosystemic shunt. Eur J Gastroentrology Hepatology 1994; 6 (08) 749-752
  • 9 Riggio O, Ricci G, Zullo A. , et al. Intravascular hemolysis and transjugular intrahepatic portosystemic stent shunt. J Hepatol 1994; 20 (01) 152-153
  • 10 Conn HO. Hemolysis after transjugular intrahepatic portosystemic shunting: the naked stent syndrome. Hepatology 1996; 23 (01) 177-181
  • 11 Brodeur MTH, Sutherland DW, Koler RD, Starr A, Kimsey JA, Griswold HE. Red blood cell survival in patients with aortic valvular disease and ball-valve prostheses. Circulation 1965; 32 (04) 570-581
  • 12 Nevaril CG, Lynch EC, Alfrey Jr CP, Hellums JD. Erythrocyte damage and destruction induced by shearing stress. J Lab Clin Med 1968; 71 (05) 784-790
  • 13 Gottlieb Y, Topaz O, Cohen LA. , et al. Physiologically aged red blood cells undergo erythrophagocytosis in vivo but not in vitro. Haematologica 2012; 97 (07) 994-1002
  • 14 Garcia-Rebollo S, González-Reimers E, Santolaria-Fernández F, Diaz-Romero F, Rodriguez-Moreno F, Martinez-Riera A. Transient hemolytic anemia after transjugular intrahepatic portosystemic stent shunt. HPB Surg 1996; 9 (04) 249-251
  • 15 Fallon E, Ehrenwald E, Nazarian GK, Smith CI. TIPS with a polytetrafluoroethylene-lined stent graft and associated haemolytic anaemia. Gut 2008; 57 (08) 1180-1181
  • 16 Abraham SA. Reversal of hemolytic anemia and hepatic encephalopathy by transjugular intrahepatic portosystemic shunt occlusion. Curr Treat Options Gastroenterol 2000; 3: 105-109