Living With HCV Or Chronic Liver Disease? Updated Videos From Advocate Karen Hoyt

Sometimes it's nice to have a place to call your own, a place that feels very much like home. Karen Hoyt has created such a place some six years ago, a safe haven with a candid look at liver disease from a patients prospective, called: I Help C.

Karen shares her own journey living with cirrhosis and liver cancer, to the emotional ups and downs of her lifesaving liver transplant. If you haven't found Karen yet, she is a master at providing patient-friendly diet and lifestyle tips for liver disease patients, filling a much needed void for people living with the hepatitis C virus (HCV) and fatty liver disease.

While we have effective drugs to cure HCV, in little as twelve to eight weeks, across all six HCV genotypes, including treatment options for people with severe liver damage, such as compensated cirrhosis, not everyone - was or is - diagnosed with HCV before serious liver damage occurs. According to a study published in Clinical Infectious Diseases and presented at CROI 2015, a substantial number of baby boomers are living with advanced liver disease. In data collected between 2010-2013, researchers reported in 2013, close to half of people born during 1945-1965 had severe fibrosis or cirrhosis. In addition, in a prospective study presented at this months Liver Meeting, close to half of people with hepatitis C, who achieved SVR (cure), were found to have fatty liver disease. The article was recently published over at Medscape.

Karen's Been Busy 

A series of  new videos is now available on Karen's YouTube channel. You'll find each video informative; from haircare tips to serious topics such as ascites, hepatic encephalopathy and other liver-related complications. Not that haircare isn't a serious topic, nuff said!

To help guide you through a well-balanced diet, which is essential to help fight or curtail liver damage, Karen published: The Liver Loving Diet. The book is a labor of love, a huge undertaking for someone dealing with Hepatic Encephalopathy (HE), a serious disorder that can happen without warning if you have advanced liver disease, causing confusion, brain fatigue (brain fog) and problems with hand movements, making concentration and typing difficult. Get to know Karen better by reading an excerpt from her book: Emergency Room Diagnosis with Liver Cirrhosis.

In this uncertain world, there are few people who help others without expecting something in return. In her own modest way, with an open heart, Karen is determined to improve the lives of people struggling with liver disease, an act of kindness that does not go unnoticed.

AASLD: Adult Patients with Ascites Due to Cirrhosis- New Update of Practice Guideline Released

The American Association for the Study of Liver Diseases (AASLD) has released an update of the practice guideline on the Management of Adult Patients with Ascites Due to Cirrhosis last published in 2009 in the journal HEPATOLOGY.

Cirrhosis is the eighth leading cause of death in the United States and ascites is the most common complication of cirrhosis.

The practice guideline is intended for physicians and allied health professionals and provides recommendations for the diagnosis and treatment of ascites. This update includes new sections on umbilical hernias, hepatic hydrothorax, and cellulitis. Click here to access the updated practice guideline.

AASLD News: April 11, 2013

Chronic HCV linked to hypertension, congestive heart failure

Chronic HCV linked to hypertension, congestive heart failure
Younossi ZM. Aliment Pharmacol Ther. 2013;37:647-652.

February 27, 2013
Patients with chronic hepatitis C are more likely to have hypertension, in addition to insulin resistance and diabetes, and also are at elevated risk for congestive heart failure, according to recent results.

Researchers evaluated data from 19,741 participants in the National Health and Nutrition Examination Survey between 1999 and 2010. The cohort included 173 patients with chronic HCV, with the remaining 19,568 classified as controls.
Full Story »

Midodrine, clonidine improve ascites control in patients with cirrhosis
Singh V. Am J Gastroenterol. 2013;doi:10.1038/ajg.2013.9.

February 26, 2013

Patients with cirrhosis and ascites treated with standard care and midodrine, clonidine or both therapies experienced improvement to hemodynamics and ascites control compared with standard care alone in a recent pilot study.
More »

FDA Grants Orphan-Drug Designation for Novel Terlipressin Formulation for the Treatment of Ascites

FDA Grants Orphan-Drug Designation for Novel Terlipressin Formulation for the Treatment of Ascites

 

BOTHELL, Wash. and CHICAGO, Jan. 4, 2013 -- PharmaIN Corporation and LAT Pharma LLC today announced that the US Food and Drug Administration (FDA) has granted their request for orphan-drug designation for terlipressin for the treatment of ascites due to all etiologies except for cancer. Ascites, or fluid accumulation in the abdomen, is a serious complication of liver cirrhosis. The companies' lead new drug candidate PHT101 (or PGC-C12E-Terlipressin) incorporates novel drug delivery technologies that may enable once-daily administration via subcutaneous injection dosing in chronic outpatient populations.

 

Chronic liver disease/cirrhosis is the 12th leading cause of death due to disease in the US, killing an estimated 27,000 people each year. Approximately 60% of cirrhosis patients eventually develop ascites. Ascites patients face a significantly increased risk of other life-threatening complications, such as spontaneous bacterial peritonitis (SBP) and hepatorenal syndrome (HRS), with a very poor prognosis of 50% survival two years after onset. Current treatments include salt-restricted diet, high doses of diuretics, and frequent paracentesis, the removal of large volumes of ascitic fluid with a needle through the abdominal wall. People with ascites are also often candidates for liver transplantation.

 

Elijah Bolotin , PhD, President of PharmaIN, said, "Orphan-drug designation by the FDA indicates the importance of this new drug candidate to a desperately ill group of patients. We are excited about the medical potential of PHT101, which synergistically incorporates two of our proprietary technologies designed to enable safer and more effective drug therapy: PGC-Hydrophobic Core nanocarrier-based delivery and unique fatylation that leads to a pro-drug."

 

"Orphan-drug designation represents a major milestone toward making PHT101 available to patients suffering from ascites due to liver cirrhosis," said John Thottathil , PhD, Chief Scientific Officer of LAT Pharma. "PHT101 would bring a novel, mechanistic approach to ascites therapy as opposed to the current standard of care involving symptom relief. Orphan status may accelerate our clinical development program. It also opens the door to special funding opportunities, such as the Orphan Product Grants Program, and provides important incentives to investors, including seven years of market exclusivity and certain tax credits."

 

Terlipressin reduces portal vein pressure and increases mean arterial pressure (MAP) in cirrhotic patients with splanchnic vasodilation. Increasing MAP in ascites patients could potentially down-regulate the excessive salt and water retention that leads to ascitic fluid buildup. For more than 20 years unmodified IV-bolus terlipressin has been used in Europe and Asia as rescue therapy for hepatorenal syndrome (HRS) and esophageal variceal bleeding (EVB). Scores of publications have demonstrated the safety and efficacy of IV terlipressin in hospitals, and many have suggested the medical potential of an outpatient version of the drug.

 

PHT101 is in preclinical testing and is protected by a US patent issued in 2011. International patent applications have been filed. The novel drug delivery technologies are covered by a separate patent estate.

 

About PharmaIN Corporation

Based in Bothell, WA, PharmaIN is focused on improving the efficacy, safety, and speed to market of injectable peptides/proteins (biologics) for the treatment of cirrhotic liver disease, congestive heart failure (CHF), cancer, inflammation, and other serious medical conditions. The Company has developed proprietary Protected Graft Copolymer (PGC) nanocarrier excipients (15 patent families) and other drug delivery and fatylation technologies. Unique benefits of these technologies include prolonging circulation time in the blood by protecting against enzymatic degradation while preserving drug activity; creating optimal pharmacokinetic/pharmacodynamic profiles to avoid peaks and troughs in drug concentrations; and enabling more effective targeting of cancer, inflammation, and infection sites because of the carrier's uniquely small size (10-20nm). PGC is a highly versatile nanocarrier platform as demonstrated by the improved performance of small peptides through very large proteins, both for subcutaneous and intravenous administration. For more about PharmaIN visit www.pharmain.com.

 

About LAT Pharma LLC

LAT Pharma was founded in 2006 with the express goal of inventing, developing, and commercializing a lifesaving new therapy for people afflicted with advanced liver disease and its deadly complications. Each member of the Chicago-based management team has decades of pharma/biotech industry experience primarily in the area of new drug development and commercialization. The company is supported by medical advisors who are worldwide leaders in chronic liver disease. LAT Pharma holds an exclusive global license to all unique terlipressin compounds arising from its collaboration with PharmaIN and is responsible for clinical development, marketing, and out-licensing of PHT101. For more about LAT Pharma visit www.lat-pharma.com .

 

SOURCE LAT Pharma LLC

 

http://www.prnewswire.com/news-releases/fda-grants-orphan-drug-designation-for-novel-terlipressin-formulation-for-the-treatment-of-ascites-185655002.html

 

Mayo Clinic, discusses ascites, encephalopathy, gastrointestinal bleeding, dysphagia, abdominal discomfort, and Crohn's disease.

Dr. Amy Oxentenko, Assistant Professor of Medicine at Mayo Clinic, discusses "Clinical Pearls in Gastroenterology," including ascites, encephalopathy, gastrointestinal bleeding, dysphagia, abdominal discomfort, and Crohn's disease.

Ascites Care Suboptimal at Some Veterans Affairs Facilities

By: DENISE NAPOLI, Family Practice News Digital Network

Quality of care for ascites, the most common complication of cirrhosis, was found to be suboptimal at several Veterans Affairs medical centers, reported Dr. Fasiha Kanwal and colleagues in the July issue of Gastroenterology.

"In general, care targeted at diagnosis and treatment was more likely to meet standards than preventive care," wrote Dr. Kanwal, of the Michael E. DeBakey Veterans Affairs Medical Center, Houston.

"We also found a trend towards improved outcomes in patients who met recommended quality indicators," added the investigators, although these findings "can only be regarded as preliminary."

The authors studied records from 774 patients (mean age 54.7 years, 99% male) in a database comprising 3 VA medical centers and 15 affiliated clinics in the Midwest (Gastroenterology 2012 [doi: 10.1053/j.gastro.2012.03.038]).

All patients had at least two ICD-9 codes for cirrhosis or at least one code for cirrhosis with either a code for complications of cirrhosis or an aspartate aminotransferase to platelet ratio greater than 2. The patients were seen between January 2000 and December 2007.

The authors compared data on these patients to a set of class 1 ascites care quality indicators (QIs). These indicators were derived by using the RAND/University of California, Los Angeles (UCLA), Appropriateness Method, which had been previously published elsewhere (Clin. Gastroenterol. Hepatol. 2010;8:709-17).

If a patient had been hospitalized more than once, only the first hospitalization was assessed. The rate of adherence to each QI was expressed as a percentage of subjects who received the recommended care, among those who were eligible for the QI.

The first QI assessed the percentage of new-onset ascites patients who underwent abdominal paracentesis within 30 days of diagnosis. On this measure, the VA scored 50.6%. The second indicator was whether known ascites patients admitted with either ascites or hepatic encephalopathy underwent abdominal paracentesis during the index hospitalization. Just over half (57.6%) of patients met this criterion.

The next QI was more likely to be met: 89.3% of patients who underwent abdominal paracentesis received ascitic fluid cell count and differential. Another indicator that was met for a high percentage of patients addressed whether ascites patients with normal renal function received diuretics within 30 days of diagnosis – 82.8% met this criterion.

Similarly, among hospitalized patients with spontaneous bacterial peritonitis (SBP), 72.0% received antibiotics within 24 hours before or after ascitic fluid analysis.

However, just 30% of patients with SBP who survived and were discharged from the facility received long-term outpatient antibiotics (for secondary prophylaxis) within 30 days. And just under half (49.2%) of patients admitted with a GI bleed received antibiotics during the index hospitalization.

The final QI was associated with the worst compliance rate: just 22.2% of patients with ascitic fluid total protein levels less than 1 g/dL and serum bilirubin of greater than 2.5 mg/dL received long-term outpatient antibiotics (for primary prophylaxis) within –3 to 30 days of that test result.

Next, the authors assessed which demographic or other independent factors were associated with higher QI compliance. In general, they reported that better care was inversely related to a worsening liver disease. More specifically, they found that patients who saw a gastroenterologist received higher-quality care than those who did not (odds ratio, 1.33), as did patients who were seen at a VA facility with academic affiliation, versus unaffiliated centers (OR, 1.73).

Finally, in two exploratory analyses, the authors examined how adherence to the ascites QIs affected patient outcomes.

Not surprisingly, "we found that after adjusting for age, liver disease severity, and comorbidity, patients receiving suboptimum care had 37% higher odds of death and 35% higher odds of readmission during the 12-month follow-up compared to patients who received optimum ascites care," although these figures did not reach statistical significance.

This study was supported by the 2008 American Society of Gastrointestinal Endoscopy Quality of Care Award and by the 2009 American College of Gastroenterology Clinical Research Award. The authors stated that they had no personal conflicts of interest.

http://www.familypracticenews.com/news/more-top-news/single-view/ascites-care-suboptimal-at-some-veterans-affairs-facilities/80021602f4faace1618f91e6b0b1bf52.html

Findings Confirm Benefits of Albumin in Treating Cirrhosis Patients Undergoing Large-Volume Paracentesis

KING OF PRUSSIA, Pa., March 28, 2012 /PRNewswire via COMTEX/

Administration of albumin reduces morbidity and mortality in cirrhotic patients undergoing large-volume paracentesis due to severe ascites, according to a new meta-analysis published online today in Hepatology, the official journal of the American Association for the Study of Liver Diseases. Compared with alternative treatments, albumin, a natural plasma-derived protein that expands blood plasma volume, significantly reduced the circulatory dysfunction that often occurs after large-volume paracentesis and also significantly reduced the occurrence of hyponatremia (low blood sodium levels). In addition, risk of death was 36 percent lower in patients receiving albumin than in those receiving other treatments.

"Albumin is the gold standard for preventing circulatory dysfunction following paracentesis greater than five liters. However, other volume expanders as well as vasoconstrictors have been considered as potential alternatives," said Mauro Bernardi, M.D., Professor of Internal Medicine at Bologna University, Bologna, Italy and lead author of the meta-analysis. "Our findings, which combine all the available evidence from randomized clinical trials, confirm that albumin is the best choice for prevention of circulatory dysfunction, and for the first time show decreased incidence of hyponatremia and improved survival with albumin use." 

Within 10 years of receiving a diagnosis, the majority of patients with liver cirrhosis develop ascites, or fluid accumulation in the abdominal cavity. Symptoms include abdominal swelling, major discomfort and impaired breathing often necessitating hospitalization. Patients with ascites have a poor prognosis, with a 50 percent mortality rate over two years. To relieve the pressure caused by the excessive abdominal fluid, a procedure called paracentesis uses a needle to drain the fluid from the abdominal cavity. However, the abrupt removal of large amounts of fluid can worsen existing circulatory dysfunction, leading to a reduction in effective volemia that adversely affect the kidney and other organs. 

The meta-analysis, which included results from 17 randomized clinical trials with 1,225 total patients, found that albumin reduced the risk of post-paracentesis circulatory dysfunction by 61 percent compared with alternative treatments. The analysis also found that the risk of hyponatremia, a condition associated with worsening brain function and death, was decreased 42 percent with albumin administration compared to other treatments, further supporting the well-accepted clinical practice of infusing albumin as the first choice in adjunctive treatment for patients requiring large-volume paracentesis. 

About CSL Behring

CSL Behring is a global leader in the plasma protein biotherapeutics industry. Passionate about improving the quality of patients' lives, CSL Behring manufactures and markets a range of safe and effective plasma-derived and recombinant products and related services. The company's therapies are used in the treatment of immune deficiency disorders, hereditary angioedema, haemophilia, von Willebrand disease, other bleeding disorders and inherited emphysema. Other products are used for the prevention of hemolytic diseases in the newborn, in cardiac surgery, organ transplantation and in the treatment of burns. The company also operates one of the world's largest plasma collection networks, CSL Plasma. CSL Behring is a subsidiary of CSL Limited, a biopharmaceutical company with headquarters in Melbourne, Australia.

For more information, visit www.cslbehring.com .

Contact:Sheila A. Burke, Director, Communications & Public RelationsWorldwide Commercial OperationsCSL Behring610-878-4209 (o)484-919-2618 (c)Sheila.Burke@cslbehring.com 

SOURCE CSL Behring

Copyright (C) 2012 PR Newswire. All rights reserved

Early TIPS for Ascites Study Seeks to Improve Survival

September issue of Gastroenterology

COMMENTARY
Early TIPS for Ascites Study Seeks to Improve Survival
BY DR. THOMAS D. BOYER

The possibility that we can improvethe quality and length of life for liver disease patients, without a transplant, is one of the most exciting potentia lopportunities in our field today. Ascites,the most common complication from cirrhosis, develops in 50% of patients within10 years.1 Development of ascites reflects decompensation of the liver and is associated with an increase in morbidity and mortality.

Initially, the ascites is usually controlled easily with diuretics, but as the liver disease worsens, higher and higher doses of diuretics are required to maintain patient comfort. Eventually, diuretic treatment fails and the patient is diagnosed with refractory ascites. The current standard of care for refractory ascites consists of large volume paracentesis (LVP), coupled with an aggressive pharmacotherapy regimen.

Transjugular intrahepatic portosystemicshunt (TIPS) therapy is regarded as the last line of defense, a bridge to liver transplantation.

However, these conclusions are based on trials in which bare stents were used to create the TIPS. With covered stents that are now available, better outcomes might be possible.

Interventional radiologists and hepatologists have come together in an international trial to determine if TIPS intervention can increase transplant-free survival compared to LVP when performed earlier in the ascitic patient population.

Previous studies comparing TIPS to LVP must be revisited. Conducted in the1990s and early 2000s, these studies may have failed to consistently demonstrate increased life expectancy for three reasons.

First, mostly end-stage patients with refractory ascites were included. Second, neither therapy changes the underlying liver disease, a reason why most therapies, except transplant, have failed to show a survival benefit.

Finally, bare metal stents,which had a high failure rate, were the only option for TIPS therapy at the time.

This study is being conducted to evaluate whether newer technology like covered stents with a lower failure rate will address this last potential pitfall. The Early TIPS for Ascites Study is a randomized, multi-center study, sponsored by Gore Medical in collaboration with both hepatologists and interventional radiologists.

Given the nature of the TIPS referral pathway, the team approach will lead to better patient care, more coordinated medical management, and improved recruitment. The goal of the study is to determine whether patients with difficult-to-treat ascites benefit most from early TIPS therapy using a covered stent or from continued LVP,based on transplant-free survival.

This study has survival as its primary endpoint, in contrast to previous trials, which looked at control of ascites. There is little question that TIPS is better than LVP in controlling the ascites. But controlled trials have shown that use of TIPS is associated with more encephalopathy than alternative forms of therapy.1

What is unclear is the balance of these two factors and the over all impact on survival. This study will also differ from prior studies that focused on refractory ascites, because the Early TIPS forAscites Study protocol allows for enrollment of patients prior to reaching the refractory stage as defined by TheInternational Ascites Club. This is also the first study of its kind in which the Modelfor End-Stage Liver Disease score is used for patient selection and will also be tracked during follow-up as a study end point.

Previous studies comparing TIPS with bare metal stents to LVP in patients with refractory ascites had mixed findings.2 Yet arecent meta-analysis of these studies found that TIPS patients had significantly longer transplant-free survival than paracentesis patients.3 And a study published last year in the New England Journal of Medicine4 compared early TIPS intervention with a covered stent to pharmacotherapy/endoscopicband ligation in high-risk variceal bleeding patients, with positive results.

TIPS therapy is a minimally invasive procedure done with closed surgery, as only a small puncture is made in the jugular vein for insertion of the device. A TIPS creates a functional side-to-side portocaval shunt to route blood flow through the damaged liver and into the main blood vessels that carry blood back to the heart.

With the TIPS procedure, alternative treatments such as medications and paracentes is for ascites, and endoscopic treatment of varices, may possibly not be needed as often. Some reports have shown significant improvements in TIPS therapy when using a covered stent versus a bare metal stent.5,6

As one of the national principal investigators for the Early TIPS for Ascites Study, I believe that the possibility of prolonging patient lives is one of the most exciting new questions in TIPS therapy that we must answer. Most treatments for complications of portal hypertension improve the patient’s condition without affecting survival. We believe that if survival improves in the TIPS cohort, the paradigm for management of cirrhotic ascites might change significantly.

■THOMAS D. BOYER, M.D., is Director ofthe Arizona Liver Research Institute,Professor of Medicine, and Medical Director of the University Medical CenterLiver Transplant Program, University ofArizona College of Medicine, Tucson.References1. Hepatology 2005;41:386-400.2. Hepatology 2009;49:2087-107.3.
Gastroenterology 2007;133:825-34.4. N. Engl. J. Med. 2010;362:2370-9.5. Hepatology 2003;38:1043-50.6. Liver International 2007;27:742-7

Midodrine Controls Ascites, Improves Survival in Cirrhotic Patients

NEW YORK (Reuters Health) Aug 04 - The alpha1-adrenergic agonist midodrine improves ascites control and may also reduce mortality, a new pilot study suggests.

Current options for treating ascites include serial paracentesis, liver transplantation, transjugular intrahepatic portosystemic shunting, and peritoneovenous shunting.

In their report of the new study, Dr. Virendra Singh and colleagues from the Postgraduate Institute of Medical Education & Research in Chandigarh, India, say "it is possible that vasoconstrictors may reverse some of the pathogenic events that result in increased renal sodium retention and refractoriness to diuretic therapy" in cirrhotic patients with ascites.

As reported in the Journal of Hepatology online July 11th, they randomly assigned 40 patients to standard medical therapy or standard medical therapy plus midodrine for six months. Twenty-eight had tense ascites that recurred at least three times in the course of 12 months despite standard treatment, and the other 12 had ascites that could not be mobilized or would return early despite a sodium-restricted diet and diuretic treatment.

All patients had stable renal function.

Standard therapy consisted of a sodium-restricted diet, furosemide, spironolactone, and large-volume paracentesis with intravenous albumin as required. Patients in the midodrine group received 7.5 mg of the drug every eight hours.

At one month, patients in the midodrine group showed an increase in mean arterial pressure, while the standard medical therapy group did not. Urinary volume and urine sodium excretion also increased significantly in patients on midodrine, but not in the control group.

Patients in the midodrine group also showed significant reductions in plasma renin activity and plasma aldosterone concentrations after one month on the drug, while patients on medical therapy alone did not.

Model for end-stage liver disease (MELD) score increased at one, three and six months for patients in the standard medical therapy group but did not change from baseline in the midodrine group.

Patients in the midodrine group survived for a median of one year, while median survival was 90 days for the control group. During follow-up, eight patients in the midodrine group and 15 in the control group died; a Kaplan-Meier survival curve showed that mortality was significantly higher in the standard medical therapy group.

"The results...suggest that long-term midodrine plus standard medical therapy improves systemic hemodynamics and better controls ascites without any renal or hepatic dysfunction in nonazotemic patients with refractory or recurrent ascites with cirrhosis as compared to standard medical therapy alone," the researchers conclude.

SOURCE: http://bit.ly/pPQYD0

J Hepatol 2011.

First Patient Enrolled in Gore Early TIPS for Ascites Study at Indiana University Hospital

Clinical Study to Examine Effects of Early Intervention with Transjugular Intrahepatic Portosystemic Shunt (TIPS) Therapy on Transplant-Free Liver Disease Survival Rates

FLAGSTAFF, Ariz.--(BUSINESS WIRE)--W. L. Gore & Associates (Gore) today reported the first patient enrolled in the Gore Early TIPS for Ascites Study. The patient was treated at Indiana University Hospital in Indianapolis, Ind. The objective of this prospective, randomized, multi-center clinical study is to evaluate whether the TIPS procedure with the GORE^® VIATORR^® TIPS Endoprosthesis improves transplant-free survival when compared to large volume paracentesis (LVP) in patients with cirrhosis of the liver and difficult to treat ascites. The study is expected to be the largest and most rigorous multi-disciplinary collaboration with hepatologists and interventional radiologists looking at early TIPS therapy. A total of 150 subjects will be enrolled at approximately 20 sites. At Indiana University Hospital the study is being led by Raj Vuppalanchi, MD, Assistant Professor of Clinical Medicine in the Division of Gastroenterology / Hepatology and David Agarwal, MD, Associate Professor of Clinical Radiology in the Department of Radiology.

“Indiana University Hospital is pleased to be the first facility to treat a patient in this important study aimed at prolonging the lives of patients and providing more than just a bridge to transplant”

“Indiana University Hospital is pleased to be the first facility to treat a patient in this important study aimed at prolonging the lives of patients and providing more than just a bridge to transplant,” said Drs. Vuppalanchi and Agarwal. “The possibility exists that we may reduce the need for alternative treatments such as medication and paracentesis; potentially improving the quality of lives for those with liver disease as well.”
Ascites is the build up of fluid in the abdomen, a result of liver disease. The current standard of care for patients is drainage of the fluid via a procedure known as paracentesis, in combination with pharmacotherapy. TIPS therapy is a minimally invasive procedure with closed surgery, as only a small puncture is needed in the jugular vein for insertion of the GORE^® VIATORR^® TIPS Device. A TIPS creates a new channel to route blood flow through the damaged liver and into the main blood vessels that lead blood back to the heart.

The GORE^® VIATORR^® TIPS Endoprosthesis is the only covered stent that is indicated for TIPS creation and revision. Data shows that the device has changed the landscape in TIPS procedures and optimized primary patency rates in the process. Fundamental and significant improvements in TIPS therapy are seen when using a covered stent versus a bare metal stent.
“Most treatments for complications of portal hypertension improve the patient’s condition without an impact on survival,” said Thomas Boyer, MD, Chief of the Arizona Liver Institute and national principal investigator for the Gore clinical study. “We believe in this new TIPS study for early resistant ascites and that an improvement in survival will be seen.”

ABOUT W. L. GORE & ASSOCIATES
The Gore Medical Products Division has provided creative therapeutic solutions to complex medical problems for three decades. During that time, more than 30 million innovative Gore Medical Devices have been implanted, saving and improving the quality of lives worldwide. The extensive Gore Medical family of products includes vascular grafts, endovascular and interventional devices, surgical meshes for hernia repair, soft tissue reconstruction, staple line reinforcement and sutures for use in vascular, cardiac and general surgery. Gore was recently named one of the best companies to work for by Fortune magazine for the 14th consecutive year. For more information, visit http://cts.businesswire.com/ct/CT?id=smartlink&url=http%3A%2F%2Fwww.goremedical.com&esheet=6694675&lan=en-US&anchor=http%3A%2F%2Fwww.goremedical.com&index=4&md5=64f4ee0876e0bc14fb5bcab3f26c5b3d.
Products listed may not be available in all markets. GORE^®, VIATORR^®, and designs are trademarks of W. L. Gore & Associates. © 2011 W. L. Gore & Associates, Inc

Contacts

Chempetitive Group for W.L. Gore & Associates
Erik Clausen or Kena Hudson, (510) 908-0966
GoreMedical@Chempetitive.com