Transesophageal Intrahepatic Portosystemic Shunts Compared with Sclerotherapy
Authors: Rafael Granados
Journal: Annals of Internal Medicine (1998)

Letters1 January 1998Transesophageal Intrahepatic Portosystemic Shunts Compared with SclerotherapyRafael Granados, MD, Juan Cabrera, MD, and Manuel Maynar, MDRafael Granados, MDHospital Universitario Nuestra Senora del Pino; Las Palmas de Gran Canaria, Spain, Juan Cabrera, MDHospital Universitario Nuestra Senora del Pino; Las Palmas de Gran Canaria, Spain, and Manuel Maynar, MDHospital Universitario Nuestra Senora del Pino; Las Palmas de Gran Canaria, SpainAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-1-199801010-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read Sanyal and colleagues' recent article with interest [1]. In their study, transjugular intrahepatic portosystemic shunts (TIPS) were associated with a higher mortality rate than was sclerotherapy, despite similar rebleeding rates in both groups. To date, four randomized, controlled trials comparing TIPS with sclerotherapy for the prevention of recurrent variceal hemorrhage have been published in peer-reviewed journals [1-4]. In all but one trial [1], TIPS were superior to sclerotherapy for prevention of rebleeding and survival rates were similar in the two treatment groups.We have assessed some of the potential sources of heterogeneity or reasons for ...References1. Sanyal AJ, Freedman AM, Luketic VA, Purdum PP 3d, Shiffman ML, Cole PE, et al. Transjugular intrahepatic portosystemic shunts compared with endoscopic sclerotherapy for the prevention of recurrent variceal hemorrhage. A randomized, controlled trial. Ann Intern Med. 1997; 126:849-57. Google Scholar2. Cabrera J, Maynar M, Granados R, Gorriz E, Reyes R, Pulido-Duque JM, et al. Transjugular intrahepatic portosystemic shunt versus sclerotherapy in the elective treatment of variceal hemorrhage. Gastroenterology. 1996; 110:832-9. Google Scholar3. Cello JP, Ring EJ, Olcott EW, Koch J, Gordon R, Sandhu J, et al. Endoscopic sclerotherapy compared with percutaneous transjugular intrahepatic portosystemic shunt after initial sclerotherapy in patients with acute variceal hemorrhage. A randomized, controlled trial. Ann Intern Med. 1997; 126:858-65. Google Scholar4. Rossle M, Deibert P, Haag K, Ochs A, Olschewski M, Siegerstetter V, et al. Randomised trial of transjugular-intrahepatic-portosystemic shunt versus endoscopy plus propranolol for prevention of variceal rebleeding. Lancet. 1997; 349:1043-9. Google Scholar Author, Article, and Disclosure InformationAuthors: Rafael Granados, MD; Juan Cabrera, MD; Manuel Maynar, MDAffiliations: Hospital Universitario Nuestra Senora del Pino; Las Palmas de Gran Canaria, Spain PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 January 1998Volume 128, Issue 1Page: 71KeywordsCirrhosisDeath ratesHemorrhageLiverMortalityPopulation statisticsSalvage antiretroviral therapy ePublished: 15 August 2000 Issue Published: 1 January 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...