Long-term shunt patency and overall survival of transjugular intrahepatic portosystemic shunt placement using covered stents with bare stents versus covered stents alone

AIM: To investigate the long-term shunt patency and overall survival of transjugular intrahepatic portosystemic shunt (TIPS) placement using covered stents with or without bare stents over a follow-up period up to 7 years. MATERIALS AND METHODS: A total of 154 patients undergoing TIPS placement were enrolled and analysed retrospectively. They were divided into two groups: those undergoing TIPS placement using covered with bare stents (group A, n = 42) and those without bare stents (group B, n = 112). RESULTS: The cumulative 5-year primary patency rate was significantly lower in group A than in group B (group A: 0% versus group B: 66.7%; p<0.001). The cumulative 5-year overall survival rates were comparable between the two groups (group A: 76% versus group B: 58.7%; p = 0.214). The baseline portal vein thrombosis (hazard ratio [HR]: 4.610; 95% confidence interval [CI]: 2.691-7.897; p = 0.000), portal pressure decrement (HR: 0.911; 95% CI: 0.845-0.982; p = 0.015), and group (HR: 0.419; 95% CI: 0.239-0.736; p = 0.002) were independent predictors for shunt dysfunction, while hepatocellular carcinoma (HR: 6.615; 95% CI: 2.863-15.283; p = 0.000) and ascites (HR: 2.166; 95% CI: 1.298-3.615; p = 0.003) were independent predictors for mortality. CONCLUSIONS: Although TIPS placement using covered with bare stents led to lowered long-term shunt patency than using covered stents alone, the overall survival rates were similar. (C) 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.