Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Portal Hypertension Using Memotherm Stents: A Prospective Multicenter Study

被引：0

作者：

Dirk Domagk

David Patch

Robert Dick

Maurizio Grosso

Hervé Rousseau

Philippe Otal

Pierre Goffette

Achim Heinecke

Markus Drees

Wolfram Domschke

Josef Menzel

机构：

[1] Department of Medicine B,

[2] University of Muenster,undefined

[3] Muenster,undefined

[4] Germany,undefined

[5] Department of Diagnostic Radiology,undefined

[6] Royal Free Hospital,undefined

[7] London,undefined

[8] UK,undefined

[9] Department of Radiology,undefined

[10] University of Turin,undefined

[11] Turin,undefined

[12] Italy,undefined

[13] Department of Radiology,undefined

[14] Centre Hospitalier Universitaire-Hôpital de Rangueil,undefined

[15] Toulouse,undefined

[16] France,undefined

[17] Department of Radiology,undefined

[18] University Hospital Saint-Luc,undefined

[19] Catholic University of Louvain,undefined

[20] Brussels,undefined

[21] Belgium,undefined

[22] Department of Medical Statistics,undefined

[23] University of Muenster,undefined

[24] Muenster,undefined

[25] Germany,undefined

来源：

CardioVascular and Interventional Radiology | 2002年 / 25卷

关键词：

Critical Condition; Portal Hypertension; Wilcoxon Test; Transjugular Intrahepatic Portosystemic Shunt; Early Mortality;

D O I：

暂无

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学科分类号：

摘要：

Purpose: In a prospective multicenter study, efficacy and safety of transjugular intrahepatic portosystemic shunts (TIPS) were evaluated in the treatment of the complications of portal hypertension using a new self-expanding mesh-wire stent (Memotherm). Methods: One hundred and eighty-one patients suffering from variceal bleeding (either acute or recurrent) or refractory ascites were enrolled. Postinterventional follow-up lasted for 8.4 months on average. Differences were analyzed by the log-rank test (chi-square) or Wilcoxon test. Results: Shunt insertion was completed successfully in all patients (n = 181 patients, 100%). During follow-up, shunt occlusion was evident in 23 patients, and shunt stenosis was found in 33 patients (12.7% and 18.2%, respectively). Variceal rebleeding occurred in 20 of 139 patients (14.4%), with at least one episode of bleeding before TIPS treatment. The overall mortality rate of the patients treated by TIPS was 39.8%. In 51.4% of these cases (37 of 72 patients), however, the patients died within 30 days after TIPS placement. Analysis of subgroups showed that patients who underwent emergency TIPS for acute variceal bleeding had a significantly higher early mortality compared with other patient groups (p = 0.0014). Conclusion: In the present prospective multicenter study, we were able to show that insertion of Memotherm stents is an effective tool for TIPS. The occlusion rates seem to be comparable to those reported for the Palmaz stent. It could be shown that in particular, those patients who were treated for acute bleeding were at high risk of early mortality. Consequently, in such a critical condition, the indication for TIPS has to be set carefully.

引用

页码：506 / 512

页数：6