PuSH - Publikationsserver des Helmholtz Zentrums München: Technical and clinical outcome of transjugular intrahepatic portosystemic stent shunt: Bare metal stents (BMS) versus viatorr stent-grafts (VSG).

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Sommer, C.M.* ; Gockner, T.L.* ; Stampfl, U.* ; Bellemann, N.* ; Sauer, P.* ; Ganten, T.* ; Weitz, J.* ; Kauczor, H.U.* ; Radeleff, B.A.*

Technical and clinical outcome of transjugular intrahepatic portosystemic stent shunt: Bare metal stents (BMS) versus viatorr stent-grafts (VSG).

Eur. J. Radiol. 81, 2273-2280 (2012)

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Open Access Green möglich sobald Postprint bei der ZB eingereicht worden ist.

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PURPOSE: To compare retrospectively angiographical and clinical results in patients undergoing transjugular intrahepatic portosystemic stent-shunt (TIPS) using BMS or VSG. MATERIALS AND METHODS: From February 2001 to January 2010, 245 patients underwent TIPS. From those, 174 patients matched the inclusion criteria with elective procedures and institutional follow-up. Group (I) consisted of 116 patients (mean age, 57.0±11.1 years) with BMS. Group (II) consisted of 58 patients with VSG (mean age, 53.5±16.1 years). Angiographic and clinical controls were scheduled at 3, 6 and 12 months, followed by clinical controls every 6 months. Primary study goals included hemodynamic success, shunt patency as well as time to and number of revisions. Secondary study goals included clinical success. RESULTS: Hemodynamic success was 92.2% in I and 91.4% in II (n.s.). Primary patency was significantly higher in II compared to I (53.8% after 440.4±474.5 days versus 45.8% after 340.1±413.8 days; p<0.05). The first TIPS revision was performed significantly later in II compared to I (288.3±334.7 days versus 180.1±307.0 days; p<0.05). In the first angiographic control, a portosystemic pressure gradient ≥15 mmHg was present in 73.9% in I and in 39.4% in II (p<0.05). Clinical success was 73.7-86.2% after 466.3±670.1 days in I and 85.7-90.5% after 617.5±642.7 days in II (n.s.). Hepatic encephalopathy was 37.5% in I and 36.5% in II (n.s.). CONCLUSION: VSG increased primary shunt patency as well as decreased time to and number of TIPS revisions. There was a trend of higher clinical success in VSG without increased hepatic encephalopathy.

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