Diagnostic and Interventional Radiology
Interventional Radiology - Original Article

Outcomes of transjugular intrahepatic portosystemic shunt using 12mm diameter polytetrafluoroethylene covered stents in cirrhotic patients with portal hypertension

1.

University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA

2.

Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA

3.

Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA

4.

Division of Preventative Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA

Diagn Interv Radiol 2020; 1: -
Read: 150 Published: 22 February 2021

PURPOSE: To evaluate the safety and efficacy of 12mm diameter PTFE-covered stents for the creation of TIPS in cirrhotic patients with portal hypertension complicated by variceal bleeding and volume-overload.

METHODS: This retrospective study included 360 patients who had TIPS created between January 2004 and December 2017 using 12mm diameter PTFE-covered stents. Demographic data, model for end-stage liver disease (MELD) score, etiology of cirrhosis, and Charlson co-morbidity index were recorded. Symptoms of hepatic encephalopathy (HE), variceal re-bleeding, improvement in volume-overload, TIPS revisions and the need for intervention, and overall survival were assessed.

RESULTS: The mean age of the patients was 56.8 years (SD=9.9), and the technical success was 99.4%. The rates of improvement of volume-overload post-TIPS were 59.5%, 69.8% and 81.7% at three, six and 12 months, respectively. 93.3% of patients were free from paracentesis or thoracentesis at 12 months. The rates of re-bleeding post-TIPS were 4%, 12% and 12.9% at three, six, and 12 months, respectively. The rate of TIPS revision at 12 months was 6.5%. Percentage of patients with any symptoms of HE were 34.4%, 42.9% and 49.5% at three, six, and 12 months, respectively. All HE was appropriately medically managed and no patients required a TIPS reduction.

CONCLUSION: TIPS placement using 12mm PTFE-covered stents is efficacious in cirrhotic patients with portal hypertension complicated by variceal bleeding or refractory volume-overload, with an acceptable safety profile.
 

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