Early Treament of Variceal Bleeding through Transjugular Intrahepatic Portosystemic Shunt (TIPS)

Portal hypertension, or increased blood pressure in the portal vein and its tributaries, is a major contributor to variceal bleeding, which is commonly found in patients of Cirrhosis and is a major cause of death. Pharmacological treatments coupled with endoscopic techniques are the current standard treatment for patients who exhibit variceal treatment. Thus the paper introduces transjugular intrahepatic portosystemic shunt (TIPS) to effectively control the variceal bleeding in patients. Although this was an effective treatment for the bleeding, it did not significantly reduce mortality rate as further liver deterioration lead to other detrimental problems such as liver failure. The study conducted a random selection of 63 patients, where 31 were given the standard treatment while 32 were assigned the TIPPs treatment. The study found that early treatment using TIPS along with a stent covered with extended polytetrafluoroethylene can improve outcomes in a patient with variceal bleeding and cirrhosis.

I found this article to be interesting as it was a direct application of bioengineering in the medical world that in fact showed promising results. It was also new to me, as when I think of biological technology I immediately think of prosthetics and stents, but it brings to light that the field is vast and there are multiple areas that are influenced by bioengineering. A few points I also liked is the fact that they specifically made note of its shortcomings and showed that it was not the end-all cure, and there was room for improvement. In addition, I have a family friend who has Cirrhosis, but his case isn't as severe as the patients that were used in the study. However this article still had particular relevance to me.

http://www.nejm.org/doi/full/10.1056/NEJMoa0910102#t=articleMethods