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2. OC.11.1: UNDERDILATION STRATEGY FOR TIPS PLACEMENT REDUCES INCIDENCE OF OVERT HEPATIC ENCEPHALOPATHY WITHOUT AFFECTING CLINICAL EFFICACY AND SURVIVAL: RESULTS OF A MULTICENTER PROSPECTIVE ITALIAN STUDY

Author

Saltini, D., primary, Nardelli, S., additional, Addotti, V., additional, Biribin, L., additional, Guasconi, T., additional, Gioia, S., additional, Caporali, C., additional, Bianchini, M., additional, Rosi, M., additional, Roccarina, D., additional, Ridola, L., additional, Casari, F., additional, Prampolini, F., additional, Indulti, F., additional, Cuffari, B., additional, Ragozzino, L., additional, De Maria, N., additional, Colecchia, A., additional, Senzolo, M., additional, Merli, M., additional, Marra, F., additional, Riggio, O., additional, Vizzutti, F., additional, and Schepis, F., additional

Published
2024
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3. BOC.02.7: UNDERDILATED NEOADJUVANT-TIPS IN PATIENTS WITH CIRRHOSIS AND PORTAL HYPERTENSION CANDIDATES TO OPERATIVE INTERVENTIONS

Author

Saltini, D., primary, Guasconi, T., additional, Ingravallo, A., additional, Indulti, F., additional, Caporali, C., additional, Gitto, S., additional, Falcini, M., additional, Bianchini, M., additional, Cuffari, B., additional, Scoppettuolo, R., additional, Prampolini, F., additional, Casari, F., additional, De Maria, N., additional, Marra, F., additional, Colecchia, A., additional, Vizzutti, F., additional, and Schepis, F., additional

Published
2024
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4. BOC.02.4: EPISODIC OVERT HEPATIC ENCEPHALOPATHY AFTER TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT DOES NOT INCREASE MORTALITY IN PATIENTS WITH CIRRHOSIS

Author

Nardelli, S., primary, Riggio, O., additional, Marra, F., additional, Gioia, S., additional, Saltini, D., additional, Bellafante, D., additional, Adotti, V., additional, Guasconi, T., additional, Ridola, L., additional, Rosi, M., additional, Caporali, C., additional, Fanelli, F., additional, Roccarina, D., additional, Bianchini, M., additional, Indulti, F., additional, Spagnoli, A., additional, Merli, M., additional, Vizzutti, F., additional, and Schepis, F., additional

Published
2024
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5. Episodic overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt does not increase mortality in patients with cirrhosis

Author

Nardelli, S., primary, Riggio, O., additional, Marra, F., additional, Gioia, S., additional, Saltini, D., additional, Bellafante, D., additional, Adotti, V., additional, Guasconi, T., additional, Ridola, L., additional, Rosi, M., additional, Caporali, C., additional, Fanelli, F., additional, Roccarina, D., additional, Bianchini, M., additional, Indulti, F., additional, Spagnoli, A., additional, Merli, M., additional, Vizzutti, F., additional, and Schepis, F., additional

Published
2024
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6. Response to “Hepatic encephalopathy and survival after transjugular intra-hepatic portosystemic shunt: do spontaneous portosystemic shunts matter?”

Author

Nardelli, S., primary, Riggio, O., additional, Marra, F., additional, Gioia, S., additional, Saltini, D., additional, Bellafante, D., additional, Adotti, V., additional, Guasconi, T., additional, Ridola, L., additional, Rosi, M., additional, Caporali, C., additional, Fanelli, F., additional, Roccarina, D., additional, Bianchini, M., additional, Indulti, F., additional, Spagnoli, A., additional, Merli, M., additional, Schepis, F., additional, and Vizzutti, F., additional

Published
2024
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7. Quality of life in liver transplant recipients during the Corona virus disease 19 pandemic: A multicentre study

Author

Gitto, S., Golfieri, L., Mannelli, N., Tame, M. R., Lopez, I., Ceccato, R., Montanari, S., Falcini, M., Vitale, G., De Maria, N., Presti, D. L., Marzi, L., Mega, A., Valente, G., Borghi, A., Foschi, F. G., Grandi, S., Forte, P., Cescon, M., Di Benedetto, F., Andreone, P., Arcangeli, G., De Simone, P., Bonacchi, A., Sofi, F., Morelli, M. C., Petranelli, M., Lau, C., Marra, F., Chiesi, F., Vizzutti, F., Vero, V., Di Donato, R., Berardi, S., Pianta, P., D'Anzi, S., Schepis, F., Gualandi, N., Miceli, F., Villa, E., Piai, G., Valente, M., Campani, C., Lynch, E., Magistri, P., Cursaro, C., Chiarelli, A., Carrai, P., Petruccelli, S., Dinu, M., and Pagliai, G.

Subjects
liver transplant, Hepatology, quality of life, COVID-19
Published
2022

8. Transjugular intra-hepatic portosystemic shunt (TIPS) in elderly patients: preliminary analysis of a multicenter retrospective cohort.

Author

Roccarina, D., primary, Turco, L., additional, Campani, C., additional, Saltini, D., additional, Aspite, S., additional, Calvaruso, V., additional, Arena, U., additional, Senzolo, M., additional, Fanelli, F., additional, Caporali, C., additional, Gitto, S., additional, Citone, M., additional, Di Bonaventura, C., additional, Schepis, F., additional, Vizzutti, F., additional, Riggio, O., additional, Burra, P., additional, Villa, E., additional, Cammà, C., additional, Marra, F., additional, and Bianchini, M., additional

Published
2022
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12. Underdilation strategy for TIPS placement reduces incidence of overt hepatic encephalopathy without affecting clinical efficacy and survival: results of a multicenter prospective Italian study

Author

Saltini, D., Nardelli, S., Addotti, V., Biribin, L., Guasconi, T., Gioia, S., Caporali, C., Bianchini, M., Rosi, M., Roccarina, D., Ridola, L., Casari, F., Prampolini, F., Indulti, F., Cuffari, B., Ragozzino, L., De Maria, N., Colecchia, A., Senzolo, M., Merli, M., Marra, F., Riggio, O., Vizzutti, F., and Schepis, F.

Published
2024
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15. Under-dilated TIPS Associate With Efficacy and Reduced Encephalopathy in a Prospective, Non-randomized Study of Patients With Cirrhosis

Author

Schepis, F, Vizzutti, F, Garcia-Tsao, G, Marzocchi, G, Rega, L, De Maria, N, Di Maira, T, Gitto, S, Caporali, C, Colopi, S, De Santis, M, Arena, U, Rampoldi, A, Airoldi, A, Cannavale, A, Fanelli, F, Mosconi, C, Renzulli, M, Agazzi, R, Nani, R, Quaretti, P, Fiorina, I, Moramarco, L, Miraglia, R, Luca, A, Bruno, R, Fagiuoli, S, Golfieri, R, Torricelli, P, Di Benedetto, F, Belli, L, Banchelli, F, Laffi, G, Marra, F, Villa, E, Schepis F., Vizzutti F., Garcia-Tsao G., Marzocchi G., Rega L., De Maria N., Di Maira T., Gitto S., Caporali C., Colopi S., De Santis M., Arena U., Rampoldi A., Airoldi A., Cannavale A., Fanelli F., Mosconi C., Renzulli M., Agazzi R., Nani R., Quaretti P., Fiorina I., Moramarco L., Miraglia R., Luca A., Bruno R., Fagiuoli S., Golfieri R., Torricelli P., Di Benedetto F., Belli L. S., Banchelli F., Laffi G., Marra F., Villa E., Schepis, F, Vizzutti, F, Garcia-Tsao, G, Marzocchi, G, Rega, L, De Maria, N, Di Maira, T, Gitto, S, Caporali, C, Colopi, S, De Santis, M, Arena, U, Rampoldi, A, Airoldi, A, Cannavale, A, Fanelli, F, Mosconi, C, Renzulli, M, Agazzi, R, Nani, R, Quaretti, P, Fiorina, I, Moramarco, L, Miraglia, R, Luca, A, Bruno, R, Fagiuoli, S, Golfieri, R, Torricelli, P, Di Benedetto, F, Belli, L, Banchelli, F, Laffi, G, Marra, F, Villa, E, Schepis F., Vizzutti F., Garcia-Tsao G., Marzocchi G., Rega L., De Maria N., Di Maira T., Gitto S., Caporali C., Colopi S., De Santis M., Arena U., Rampoldi A., Airoldi A., Cannavale A., Fanelli F., Mosconi C., Renzulli M., Agazzi R., Nani R., Quaretti P., Fiorina I., Moramarco L., Miraglia R., Luca A., Bruno R., Fagiuoli S., Golfieri R., Torricelli P., Di Benedetto F., Belli L. S., Banchelli F., Laffi G., Marra F., and Villa E.

Abstract

Background & Aims: Portosystemic encephalopathy (PSE) is a major complication of trans-jugular intrahepatic porto-systemic shunt (TIPS) placement. Most devices are self-expandable polytetrafluoroethylene-covered stent grafts (PTFE-SGs) that are dilated to their nominal diameter (8 or 10 mm). We investigated whether PTFE-SGs dilated to a smaller caliber (under-dilated TIPS) reduce PSE yet maintain clinical and hemodynamic efficacy. We also studied whether under-dilated TIPS self-expand to nominal diameter over time. Methods: We performed a prospective, non-randomized study of 42 unselected patients with cirrhosis who received under-dilated TIPS (7 and 6 mm) and 53 patients who received PTFE-SGs of 8 mm or more (controls) at referral centers in Italy. After completion of this study, dilation to 6 mm became the standard and 47 patients were included in a validation study. All patients were followed for 6 months; Doppler ultrasonography was performed 2 weeks and 3 months after TIPS placement and every 6 months thereafter. Stability of PTFE-SG diameter was evaluated by computed tomography analysis of 226 patients with cirrhosis whose stent grafts increased to 6, 7, 8, 9, or 10 mm. The primary outcomes were incidence of at least 1 episode of PSE grade 2 or higher during follow up, incidence of recurrent variceal hemorrhage or ascites, incidence of shunt dysfunction requiring TIPS recanalization, and reduction in porto-caval pressure gradient. Results: PSE developed in a significantly lower proportion of patients with under-dilated TIPS (27%) than controls (54%) during the first year after the procedure (P =.015), but the proportions of patients with recurrent variceal hemorrhage or ascites did not differ significantly between groups. No TIPS occlusions were observed. These results were confirmed in the validation cohort. In an analysis of self-expansion of stent grafts, during a mean follow-up period of 252 days after placement, none of the PTFE-SGs self-expanded to t

Published
2018

17. Assessment of sarcopenia improves the prediction of post-TIPS mortality in older adult patients with cirrhosis.

Author

Saltini, D., Nardelli, S., Vizzutti, F., Miraglia, R., Bellafante, D., Banchelli, F., Caporali, C., Maruzzelli, L., Falcone, G., Bianchini, M., Guasconi, T., Ingravallo, A., Casari, F., Prampolini, F., Colecchia, A., Marra, F., Cammà, C., Senzolo, M., Riggio, O., and Schepis, F.

Abstract

Transjugular intrahepatic portosystemic shunt (TIPS) has been demonstrated to be feasible in older adult patients (age ≥70 years), yet the selection criteria remain suboptimal. Sarcopenia, highly prevalent in elderly population, may be significantly associated with post-TIPS outcome. This study aimed at evaluating the impact of baseline sarcopenia on post-TIPS survival in older adults with cirrhosis. A retrospective analysis of the prospective Italian TIPS-Registry was conducted to identify patients ≥70 years who received TIPS from June 2015 to March 2023. The availability of baseline abdominal CT scan was a mandatory inclusion criterion. Skeletal muscle index (SMI) was evaluated at the L3-L4 level. Sarcopenia was defined as SMI <50 cm2/m2 for men and <39 cm2/m2 for women. Probability of liver-related death was evaluated by competing risks analysis. A prediction model for liver-related mortality was created. One-hundred and fifteen patients were included: median age 74 years (IQR 3.1), 62% male, median dry-BMI 25.7 (IQR 4.7), 60% prevalence of sarcopenia. The main etiologies were viral (40%), alcohol-associated cirrhosis (23%), and metabolic dysfunction-associated steatohepatitis (20%). Refractory ascites (57%) was the main indications for TIPS. During a mean follow up of 20 months (IQR 20), 40 (34.8%) patients died for liver-related causes and 16 (13.9%) for extrahepatic causes. Liver-related mortality was significantly higher in patients with sarcopenia than in those without (6-months: 25.0% vs. 2.2%; 1-year: 43.0% vs. 4.8%, respectively; p value <0.001). A predictive model including INR, creatinine, and sarcopenia was developed to estimate liver-related mortality. The model achieved good predictive performances with AUCs of 0.826, 0.788, and 0.712 at 6-month, 1-year, and 2-years, respectively. Due to its significant impact on survival, the evaluation of sarcopenia may improve the selection of older adults candidate to TIPS. The new predictive model for post-TIPS liver-related mortality deserves external validation. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Effective albumin concentration and albumin function improve after long-term albumin therapy in patients with decompensated cirrhosis

Author

Baldassarre, M., primary, Tufoni, M., additional, Zaccherini, G., additional, Campion, D., additional, Foschi, F.G., additional, Nardelli, S., additional, Morisco, F., additional, Federico, A., additional, Massironi, S., additional, Airoldi, A., additional, Vizzutti, F., additional, Antognoli, A., additional, Gagliardi, M., additional, Donadei, C., additional, Waterstradt, K., additional, Naldi, M., additional, Bernardi, M., additional, and Caraceni, P., additional

Published
2020
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19. Consensus conference on TIPS management: Techniques, indications, contraindications

Author

Fagiuoli, S, Bruno, R, Debernardi Venon, W, Schepis, F, Vizzutti, F, Toniutto, P, Senzolo, M, Caraceni, P, Salerno, F, Angeli, P, Cioni, R, Vitale, A, Grosso, M, De Gasperi, A, D'Amico, G, Marzano, A, Fagiuoli S., Bruno R., Debernardi Venon W., Schepis F., Vizzutti F., Toniutto P., Senzolo M., Caraceni P., Salerno F., Angeli P., Cioni R., Vitale A., Grosso M., De Gasperi A., D'Amico G., Marzano A., Fagiuoli, S, Bruno, R, Debernardi Venon, W, Schepis, F, Vizzutti, F, Toniutto, P, Senzolo, M, Caraceni, P, Salerno, F, Angeli, P, Cioni, R, Vitale, A, Grosso, M, De Gasperi, A, D'Amico, G, Marzano, A, Fagiuoli S., Bruno R., Debernardi Venon W., Schepis F., Vizzutti F., Toniutto P., Senzolo M., Caraceni P., Salerno F., Angeli P., Cioni R., Vitale A., Grosso M., De Gasperi A., D'Amico G., and Marzano A.

Abstract

The trans jugular intrahepatic Porto systemic shunt (TIPS) is no longer viewed as a salvage therapy or a bridge to liver transplantation and is currently indicated for a number of conditions related to portal hypertension with positive results in survival. Moreover, the availability of self-expandable polytetrafluoroethylene (PTFE)-covered endoprostheses has dramatically improved the long-term patency of TIPS. However, since the last updated International guidelines have been published (year 2009) new evidence have come, which have open the field to new indications and solved areas of uncertainty. On this basis, the Italian Association of the Study of the Liver (AISF), the Italian College of Interventional Radiology—Italian Society of Medical Radiology (ICIR-SIRM), and the Italian Society of Anesthesia, Analgesia and Intensive Care (SIAARTI) promoted a Consensus Conference on TIPS. Under the auspices of the three scientific societies, the consensus process started with the review of the literature by a scientific board of experts and ended with a formal consensus meeting in Bergamo on June 4th and 5th, 2015. The final statements presented here were graded according to quality of evidence and strength of recommendations and were approved by an independent jury. By highlighting strengths and weaknesses of current indications to TIPS, the recommendations of AISF-ICIR-SIRM-SIAARTI may represent the starting point for further studies.

Published
2017

20. Authors’ reply

Author

Vizzutti, F, Arena, U, Marra, F, and Pinzani, M

Published
2009

26. VIATORR stent grafts do not self-expand to their nominal diameters in cirrhotic livers: good news from a computed tomography-based Italian multicentric study

Author

Schepis F, Vizzutti F, Marzocchi G, Quaretti P, Rampoldi A, Agazzi R, Golfieri R, Luca A, Fanelli F, Caporali C, Colopi S, De Santis M, Rega L, Arena U, Fiorina I, Moramarco L. P, Airoldi A, Nani R, Renzulli M, Mosconi C, Bruno R, Fagiuoli S, Cannavale A, Di Maira T, Villa E, and Schepis F, Vizzutti F, Marzocchi G, Quaretti P, Rampoldi A, Agazzi R, Golfieri R, Luca A, Fanelli F, Caporali C, Colopi S, De Santis M, Rega L, Arena U, Fiorina I, Moramarco L.P, Airoldi A, Nani R, Renzulli M, Mosconi C, Bruno R, Fagiuoli S, Cannavale A, Di Maira T, Villa E

Subjects
cirrhotic liver, computed tomography, VIATORR stent graft
Published
2014

29. Non-invasive assessment of fibrosis in non-alcoholic fatty liver disease

Author

Vizzutti, F, Arena, U, Nobili, V, Tarquini, R, Trappoliere, M, Laffi, G, Marra, F, and Pinzani, M.

Subjects
Adult, Liver Cirrhosis, Adolescent, Biopsy, Reproducibility of Results, Biomarkers, Child, Elasticity Imaging Techniques, Fatty Liver, Humans, Predictive Value of Tests, Risk Assessment, Risk Factors, Severity of Illness Index
Abstract

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in Western countries, and its prevalence is increasing worldwide. It currently affects approximately 30% of adults and 10% of children and adolescents. The resulting increase in the number of patients with NAFLD is expected to translate into increased numbers of patients with liver cirrhosis, and hepatocellular carcinoma. In this context, it is particularly important to identify patients at risk for progressive chronic liver disease. Currently, liver biopsy is the gold standard to diagnose non-alcoholic steatohepatitis (NASH) and to establish the presence and stage of fibrosis. Due to the remarkable increase in the prevalence of NAFLD and the concomitant efforts in developing novel therapies for patients with NASH, non-invasive, simple, reproducible, and reliable non-invasive methodologies are needed. This paper provides a concise overview of the role of non-invasive diagnostic tools for the determination of presence and extent of fibrosis in NAFLD patients, with particular emphasis on the methods currently available in clinical practice.

Published
2009

32. Reliability of transient elastography for the diagnosis of advanced fibrosis in chronic hepatitis C.

Author

Universitat de Barcelona, Arena, U., Vizzutti, F., Abraldes, Juan G., Corti, G., Stasi, C., Moscarella, S., Milani, S., Lorefice, E., Petrarca, A., Romanelli, R.G., Laffi, G., Bosch i Genover, Jaume, Marra, F., Pinzani, M., Universitat de Barcelona, Arena, U., Vizzutti, F., Abraldes, Juan G., Corti, G., Stasi, C., Moscarella, S., Milani, S., Lorefice, E., Petrarca, A., Romanelli, R.G., Laffi, G., Bosch i Genover, Jaume, Marra, F., and Pinzani, M.

Published
2011

39. Transient elastography (TE) is more effective for the identification of HCV patients with severe (≥F3) rather than significant (≥F2) liver fibrosis

Author

Arena, U., primary, Vizzutti, F., additional, Abraldes, J.G., additional, Corti, G., additional, Stasi, C., additional, Moscarella, S., additional, Milani, S., additional, Lorefice, E., additional, Petrarca, A., additional, Laffi, G., additional, Marra, F., additional, and Pinzani, M., additional

Published
2008
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40. 762 TRANSIENT ELASTOGRAPHY (TE) IS MORE EFFECTIVE FOR THE IDENTIFICATION OF HCV PATIENTS WITH ADVANCED (F3-F4) RATHER THAN SIGNIFICANT (F2-F4) LIVER FIBROSIS

Author

Arena, U., primary, Vizzutti, F., additional, Abraldes, J.G., additional, Corti, G., additional, Stasi, C., additional, Moscarella, S., additional, Milani, S., additional, Lorefice, E., additional, Petrarca, A., additional, Laffi, G., additional, Bosch, J., additional, Marra, F., additional, and Pinzani, M., additional

Published
2008
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