E-ISSN 1305-3612
Interventional Radiology - Original Article
Long-term follow-up of transjugular intrahepatic portosystemic shunt (TIPS) with stent-graft
1 Department of Radiology, Hospital Universitari Son Espases, Palma de Mallorca, Spain  
2 Department of Digestive, Hospital Universitari Son Espases, Palma de Mallorca, Spain  
Diagn Interv Radiol ; : -

Abstract

PURPOSE: To retrospectively evaluate the long-term clinical and patency results after the placement of trans-jugular 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) 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 of 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% (95% confidence intervals [CIs], 56.2-75.8) after 6 years, primary assisted patency remained stable at 87% (95% CIs 77.2-96.8) after 6 years, and secondary patency did not decrease from 98% (95% CIs 95.1-100) after 4 years. The median overall survival was 42.8 months (95% CIs, 33.8-51.8). A total of 54 patients suffered some type of complication, minor (28 patients) or major (26 patients), during follow-up.

 

CONCLUSION: The clinical success rate was high. The choice of the maximum initial limit of PSG 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.  

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