222 Cost analysis of E-PTFE covered tips stents compared to bare stents

Ockenga, Johann; Ockenga, T; Kroencke, Thomas J.; Plauth, Mathias; Kasim, E.; Petersein, J.; Schmidt, Hartmut; Lochs, Herbert

doi:10.1016/s0168-8278(04)90222-x

Cited by 2 publications

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“…Cost-effectiveness has yet to be determined, although preliminary data suggest a reduction in costs with ePTFE-covered TIPS. 48 Anecdotally, in the authors practice over the past 10 years, a marked reduction in post-TIPS re-interventions has been noted, likely related to the predominant use of covered stents.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Transjugular Intrahepatic Portosystemic Shunts for Ascites

Bercu

Fischman

2014

Semin intervent Radiol

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Refractory ascites represents a devastating complication of portal hypertension. Transjugular intrahepatic portosystemic shunt (TIPS) is an efficacious option for patients for whom transplant is not an immediate option. Techniques to optimize the hepatic venous pressure gradient and the use of covered stents have reduced rates of hepatic encephalopathy and stent occlusion, respectively. Patients with a Model for End-Stage Liver Disease score less than 15, serum creatinine less than 2 mg/dL, and serum bilirubin less than 2 mg/dL are particularly suited for TIPS placement. TIPS is also effective for hepatic hydrothorax and for massive ascites in the posttransplant setting, although future investigations are necessary to elucidate risk factors and establish the effect on transplant-free survival.

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Section: Introductionmentioning

confidence: 99%

Outcomes of Transjugular Intrahepatic Portosystemic Shunts for Ascites

Bercu

Fischman

2014

Semin intervent Radiol

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TIPS for Refractory Ascites: A 6-Year Single-Center Experience With Expanded Polytetrafluoroethylene–Covered Stent-Grafts

Bercu

Fischman

Kim

et al. 2015

American Journal of Roentgenology

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OBJECTIVE. This single-center study evaluated the use of expanded polytetrafluoroethylene (ePTFE)-covered stent-grafts for transjugular intrahepatic portosystemic shunt (TIPS) placement to manage portal hypertension-related refractory ascites. MATERIALS AND METHODS. One hundred patients at a single tertiary care center in a major metropolitan hospital underwent TIPS placement with an ePTFE-covered stent-graft (Viatorr TIPS Endoprosthesis). Patients with portal hypertension-related ascites and preexisting hepatocellular carcinoma or liver transplant were excluded from the analysis. Records were reviewed for demographic characteristics, technical success of the TIPS procedures, and stent follow-up findings. Clinical results were assessed at 90- and 180-day intervals. RESULTS. Immediate technical success of the TIPS procedure was 100%. Of the 61 patients with documented follow-up, 55 (90.2%) had a partial or complete ascites response to TIPS creation. Of these 55 patients, nine experienced severe encephalopathy. Six of 61 patients (9.8%) did not experience a significant ascites response. Overall survival was 78.7% at 365-day follow-up. The 365-day survival was 84.2% for patients with a model for end-stage liver disease (MELD) score of less than 15, 67.0% for those with a score of 15-18, and 53.8% for those with a score of greater than 18 (p = 0.01). For patients with a MELD score of less than 18, the 365-day survival was 88.0% for those with an albumin value of 3 mg/dL or greater and 72.8% for those with an albumin value of less than 3 mg/dL (p = 0.04). CONCLUSION. TIPS placement using an ePTFE-covered stent-graft is an efficacious therapy for refractory ascites. Patients with preserved liver function-characterized by a MELD score of less than 15 or a MELD score of less than 18 and an albumin value of 3 mg/dL or greater-experience the greatest survival benefit.

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222 Cost analysis of E-PTFE covered tips stents compared to bare stents

Cited by 2 publications

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Outcomes of Transjugular Intrahepatic Portosystemic Shunts for Ascites

Outcomes of Transjugular Intrahepatic Portosystemic Shunts for Ascites

TIPS for Refractory Ascites: A 6-Year Single-Center Experience With Expanded Polytetrafluoroethylene–Covered Stent-Grafts

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