Clinical events following TIPS: Correlation with hemodynamic findings

TIPS versus drug therapy in preventing variceal rebleeding in advanced cirrhosis: A randomized controlled trial

“…[16][17][18][19][20][21][22] The frequent development of TIPS dysfunction calls for repeated angioplasty and/or restenting during the follow-up. 4,[16][17][18][19][23][24][25] Finally, TIPS does not improve survival as compared with endoscopic therapy. [16][17][18][19] Pharmacologic therapy with nonselective beta-blockers, alone or combined with isosorbide-5-mononitrate (ISMN), is widely used to prevent first variceal bleeding and rebleeding.…”

“…4 The sample size required to detect significant differences of this magnitude in a 2-sided test, with alpha ϭ 0.05 and beta ϭ 0.10, was established at 42 patients in each treatment arm.…”

“…The sample size calculation was based on the results of published meta-analyses on the efficacy of beta-blockers in preventing variceal rebleeding 36 and 3 studies for elective TIPS procedure with a mean follow-up of at least 1 year [4][5][6] (all of them published at the time the study was planned). The estimated 1-year variceal rebleeding rate for beta-blocker therapy was 46%.…”

“…2 TIPS is relatively easy to perform, quite safe, and causes a portal decompression similar to that achieved by surgical shunts. 3,4 Randomized controlled trials (RCTs) [5][6][7][8][9][10][11][12][13][14][15] and meta-analyses [16][17][18][19] have shown that TIPS is more effective than endoscopic therapy in preventing variceal rebleeding. However, some studies reported an increased incidence of encephalopathy following TIPS.…”

“…4 Wallstent endoprosthesis were used (10 mm nominal expanded diameter Wallstent; Boston Scientific, Schneider, Bülach, Switzerland). The stent was initially dilated to 8 mm in diameter and then to 10 mm in diameter if the portocaval pressure gradient (PPG) was still above 12 mm Hg.…”