Long-term follow-up of transjugular intrahepatic portosystemic shunt (TIPS) with stent-graft
PDF
Cite
Share
Request
Interventional Radiology - Original Article
P: 346-352
September 2019

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

Diagn Interv Radiol 2019;25(5):346-352
1. Department of Radiology, Hospital Universitari Son Espases, Palma de Mallorca, Spain
2. Department of Gastroenterology, Hospital Universitari Son Espases, Palma de Mallorca, Spain
No information available.
No information available
Received Date: 28.09.2018
Accepted Date: 29.12.2018
PDF
Cite
Share
Request

ABSTRACT

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.