The DOI matches its Crossref record; 20 of the 20 references it cites were found in a registry or an index.
Early Use of TIPS in Patients with Cirrhosis and Variceal Bleeding
Open accessAbstract
BACKGROUND: Patients with cirrhosis in Child-Pugh class C or those in class B who have persistent bleeding at endoscopy are at high risk for treatment failure and a poor prognosis, even if they have undergone rescue treatment with a transjugular intrahepatic portosystemic shunt (TIPS). This study evaluated the earlier use of TIPS in such patients. METHODS: We randomly assigned, within 24 hours after admission, a total of 63 patients with cirrhosis and acute variceal bleeding who had been treated with vasoactive drugs plus endoscopic therapy to treatment with a polytetrafluoroethylene-covered stent within 72 hours after randomization (early-TIPS group, 32 patients) or continuation of vasoactive-drug therapy, followed after 3 to 5 days by treatment with propranolol or nadolol and long-term endoscopic band ligation (EBL), with insertion of a TIPS if needed as rescue therapy (pharmacotherapy-EBL group, 31 patients). RESULTS: During a median follow-up of 16 months, rebleeding or failure to control bleeding occurred in 14 patients in the pharmacotherapy-EBL group as compared with 1 patient in the early-TIPS group (P=0.001). The 1-year actuarial probability of remaining free of this composite end point was 50% in the pharmacotherapy-EBL group versus 97% in the early-TIPS group (P<0.001). Sixteen patients died (12 in the pharmacotherapy-EBL group and 4 in the early-TIPS group, P=0.01). The 1-year actuarial survival was 61% in the pharmacotherapy-EBL group versus 86% in the early-TIPS group (P<0.001). Seven patients in the pharmacotherapy-EBL group received TIPS as rescue therapy, but four died. The number of days in the intensive care unit and the percentage of time in the hospital during follow-up were significantly higher in the pharmacotherapy-EBL group than in the early-TIPS group. No significant differences were observed between the two treatment groups with respect to serious adverse events. CONCLUSIONS: In these patients with cirrhosis who were hospitalized for acute variceal bleeding and at high risk for treatment failure, the early use of TIPS was associated with significant reductions in treatment failure and in mortality. (Current Controlled Trials number, ISRCTN58150114.)
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Cites
Malinchoc, M., Kamath, P. S., Gordon, F. D., Peine, C. J., Rank, J., & ter Borg, P. C. J. (2000) · Hepatology · doi:10.1053/he.2000.5852 · Cited by 2,893
de Franchis, R. (2005) · Journal of Hepatology · doi:10.1016/j.jhep.2005.05.009 · Cited by 1,029
Upper Digestive Bleeding in Cirrhosis. Post–Therapeutic Outcome and Prognostic Indicators
D'Amico, G., & De Franchis, R. (2003) · Hepatology · doi:10.1053/jhep.2003.50385 · Cited by 907
Franchis, R. D. (2000) · Journal of Hepatology · doi:10.1016/s0168-8278(00)80320-7 · Cited by 587
Prevention and Management of Gastroesophageal Varices and Variceal Hemorrhage in Cirrhosis
Garcia-Tsao, G., Sanyal, A. J., Grace, N. D., Carey, W. D., & the Practice Guidelines Committee of the American Association for the Study of Liver Diseases and the Practice Parameters Committee of the American College of Gastroenterology (2007) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2007.01481.x · Cited by 569
Monescillo, A., Martínez-Lagares, F., Ruíz-del-Árbol, L., Sierra, A., Guevara, C., Jim�nez, E., Marrero, J. M., Buceta, E., Sánchen, J., Castellot, A., et al. (2004) · Hepatology · doi:10.1002/hep.1840400408 · Cited by 536
Bureau, C., Garcia-Pagan, J. C., Otal, P., Pomier-Layrargues, G., Chabbert, V., Cortez, C., Perreault, P., Péron, J. M., G. Abraldes, J., Bouchard, L., et al. (2004) · Gastroenterology · doi:10.1053/j.gastro.2003.11.016 · Cited by 513
Self-citationPrognostic value of early measurements of portal pressure in acute variceal bleeding
Moitinho, E., Escorsell, À., Bandi, J., Salmerón, J., García–Pagán, J., Rodés, J., & Bosch, J. (1999) · Gastroenterology · doi:10.1016/s0016-5085(99)70455-5 · Cited by 485
Self-citationGoulis, J., Armonis, A., Patch, D., Sabin, C., Greenslade, L., & Burroughs, A. K. (1998) · Hepatology · doi:10.1002/hep.510270504 · Cited by 435
Bosch, J., Thabut, D., Bendtsen, F., D’Amico, G., Albillos, A., González Abraldes, J., Fabricius, S., Erhardtsen, E., & de Franchis, R. (2004) · Gastroenterology · doi:10.1053/j.gastro.2004.07.015 · Cited by 401
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Cited by
Garcia‐Tsao, G., Abraldes, J. G., Berzigotti, A., & Bosch, J. (2017) · Hepatology · doi:10.1002/hep.28906 · Cited by 2,154
Self-citationGinès, P., Krag, A., Abraldes, J. G., Solà, E., Fabrellas, N., & Kamath, P. S. (2021) · The Lancet · doi:10.1016/s0140-6736(21)01374-x · Cited by 1,663
Self-citationClinical states of cirrhosis and competing risks
D'Amico, G., Morabito, A., D'Amico, M., Pasta, L., Malizia, G., Rebora, P., & Valsecchi, M. G. (2018) · Journal of Hepatology · doi:10.1016/j.jhep.2017.10.020 · Cited by 536
Kaplan, D. E., Ripoll, C., Thiele, M., Fortune, B. E., Simonetto, D. A., Garcia-Tsao, G., & Bosch, J. (2024) · Hepatology · doi:10.1097/hep.0000000000000647 · Cited by 486
Self-citationBureau, C., Thabut, D., Oberti, F., Dharancy, S., Carbonell, N., Bouvier, A., Mathurin, P., Otal, P., Cabarrou, P., Péron, J. M., et al. (2017) · Gastroenterology · doi:10.1053/j.gastro.2016.09.016 · Cited by 452
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Metadata
- Authors
- García-Pagán, J. C., Caca, K., Bureau, C., Laleman, W., Appenrodt, B., Luca, A., Abraldes, J. G., Nevens, F., Vinel, J. P., Mössner, J., & Bosch, J.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2010-06-24
- Volume
- 362
- Issue
- 25
- Pages
- 2370-2379
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2134599653
- Cited by
- 1,244
- References
- 20
- FWCI
- 35.75
- Type
- journal article
- Language
- en
- Open access
- bronze
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