Long-term follow-up of transjugular intrahepatic portosystemic shunt (TIPS) with stent-graft

被引:21
作者
Pons Perello, Margalida [1 ]
Pueyo Mur, Javier [1 ]
Sastre Vives, Magdalena [1 ]
Martinez Riutort, Juan Manuel [1 ]
Pastor Artigues, Asuncion [1 ]
Nieto Garcia, Carolina [1 ]
Bonet Vidal, Maria Lucia [2 ]
Escarda Gelabert, Ana [2 ]
Vanrell Garau, Margalida [2 ]
机构
[1] Hosp Univ Son Espases, Dept Radiol, Palma De Mallorca, Spain
[2] Hosp Univ Son Espases, Dept Gastroenterol, Palma De Mallorca, Spain
关键词
POLYTETRAFLUOROETHYLENE-COVERED STENT; PATENCY; PLACEMENT; OUTCOMES;
D O I
10.5152/dir.2019.18416
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE We aimed to retrospectively evaluate the long-term clinical and patency results after the placement of transjugular intrahepatic portosystemic shunts (TIPS) using stent-graft. Many studies show the clinical results and the patency follow-up of TIPS with stent-graft in the short and medium term. However, few studies show long-term results. METHODS Between 2002 and 2016, TIPS with stent-grafts were placed in 132 patients. The median age was 59.5 years. The median Model for End-stage Liver Disease (MELD) score was 13, and 71% were Child-Pugh B. Indications for TIPS were bleeding (83%) and ascites or hydrothorax (17%). The technical and clinical success rates were calculated, as were the rates of patency, survival and complications. The median follow-up period was 43 months. RESULTS The technical success rate was 98%, and the clinical success rates were 85% in patients with indication for bleeding and 95% in patients with indication for ascites or hydrothorax. Primary patency did not decrease from 66% after 6 years (95% confidence interval [CI], 56.2%-75.8%) primary assisted patency remained stable at 87% after 6 years (95% CI, 77.2%-96.8%) and secondary patency did not decrease from 98% after 4 years (95% CI, 95.1%-100%). The median overall survival was 42.8 months (95% CI, 33.8-51.8 months). A total of 54 patients suffered some type of complication, minor (28 patients) or major (26 patients), during the follow-up. CONCLUSION The clinical success rate was high. The choice of the maximum initial limit of portosystemic gradient and the diameter of the post-TIPS shunt, together with the number of shunt reductions, are important to be able to compare results between publications. In our study, the patency rates did not decrease after 6 years; hence, long-term follow-up of these patients may not be necessary.
引用
收藏
页码:346 / 352
页数:7
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