Comparison of transjugular intrahepatic portosystemic shunt dysfunction in PTFE-covered stent-grafts versus bare stents

Barrio, José María; Ripoll, Cristina; Bañares, Rafael; Echenagusía, Antonio; Catalina, María‐Vega; Camúñez, F; Simó, Gonzalo Varela; Santos, Leonardo Soares dos

doi:10.1016/j.ejrad.2004.10.007

Cited by 97 publications

(83 citation statements)

References 23 publications

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“…Dedicated ePTFE-covered stents should be preferred over bare stents in order to reduce the risk of shunt dysfunction (1b, A) [18][19][20][29][30][31].…”

Section: Which Types Of Device Are Available For Tips?mentioning

confidence: 99%

“…Comment: Two RCTS [32,33] and a meta-analysis [29] of six studies (one prospective and five retrospective) comparing TIPS placement with PTFE-covered stents and bare stents for portal hypertension related complications showed that the covered stent was superior in terms of shunt dysfunction (HR = 0.28; 95% CI 0.20-0.35).…”

Section: Which Types Of Device Are Available For Tips?mentioning

confidence: 99%

See 1 more Smart Citation

Consensus conference on TIPS management: Techniques, indications, contraindications

Fagiuoli

Bruno

Venon

et al. 2017

Digestive and Liver Disease

130

120

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a b s t r a c tThe trans jugular intrahepatic Porto systemic shunt (TIPS) is no longer viewed as a salvage therapy or a bridge to liver transplantation and is currently indicated for a number of conditions related to portal hypertension with positive results in survival. Moreover, the availability of self-expandable polytetrafluoroethylene (PTFE)-covered endoprostheses has dramatically improved the long-term patency of TIPS. However, since the last updated International guidelines have been published (year 2009) new evidence have come, which have open the field to new indications and solved areas of uncertainty. On this basis, the Italian Association of the Study of the Liver (AISF), the Italian College of Interventional Radiology-Italian Society of Medical Radiology (ICIR-SIRM), and the Italian Society of Anesthesia, Analgesia and Intensive Care (SIAARTI) promoted a Consensus Conference on TIPS. Under the auspices of the three scientific societies, the consensus process started with the review of the literature by a scientific board of experts and ended with a formal consensus meeting in Bergamo on June 4th and 5th, 2015. The final statements presented here were graded according to quality of evidence and strength of recommendations and were approved by an independent jury. By highlighting strengths and weaknesses of current indications to TIPS, the recommendations of AISF-ICIR-SIRM-SIAARTI may represent the starting point for further studies.

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“…Dedicated ePTFE-covered stents should be preferred over bare stents in order to reduce the risk of shunt dysfunction (1b, A) [18][19][20][29][30][31].…”

Section: Which Types Of Device Are Available For Tips?mentioning

confidence: 99%

Section: Which Types Of Device Are Available For Tips?mentioning

confidence: 99%

Consensus conference on TIPS management: Techniques, indications, contraindications

Fagiuoli

Bruno

Venon

et al. 2017

Digestive and Liver Disease

130

120

View full text Add to dashboard Cite

show abstract

“…Accordingly, understanding the predisposing factors leading to TIPS dysfunction and efforts to solve those problems are necessary to maintain long-term patency after TIPS placement. Currently, the best solution for TIPS dysfunction seems to be the use of polytetrafluoroethylene-covered stent grafts that isolate blood from hepatic tissue, therefore blocking the tentative triggering mechanisms of pseudointimal and intimal hyperplasia or thrombosis (19)(20)(21)(22)(23)(24)(25)(26)(27). Recently, a meta-analysis of six studies demonstrated not only a significant improvement of primary patency (hazard ratio [HR], 0.28) and a significant reduction of risk of hepatic encephalopathy (HR, 0.65), but also a significant decrease of mortality in the covered-stent group (HR, 0.76) (25).…”

Section: Discussionmentioning

confidence: 99%

“…Among many theories, widely accepted ones are thrombosis, pseudointimal hyperplasia caused by bile leaks of transected bile ducts into the stent lumen, and intimal hyperplasia of the hepatic vein outflow tract (16)(17)(18). Recently, use of polytetrafluoroethylene (PTFE)-covered stents has decreased TIPS dysfunction by allowing endoluminal endothelial lining and preventing bile leak into the stent (19)(20)(21)(22)(23)(24)(25)(26)(27).…”

Section: Introductionmentioning

confidence: 99%

Stent Dysfunction After Transjugular Intrahepatic Portosystemic Shunt: A 14-Year Experience from a Single Tertiary Medical Center

Kim

Gwon

et al. 2017

Iran J Radiol

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Background: The predisposing factors leading to transjugular intrahepatic portosystemic shunt (TIPS) dysfunction, other than the use of bare stents, which are often the only available options, have not been elucidated well to date. Objectives: To analyze clinical outcomes after TIPS created with bare stents and to assess risk factors for stent dysfunction. Patients and Methods: A total of 102 patients undergoing TIPS between January 1999 and December 2012 were retrospectively assessed. The incidence of stent dysfunction was evaluated, and associated risk factors were analyzed. Results: Symptom recurrence was observed in 51 (50%) patients, and TIPS revision was required in 37 (36%) during the mean followup period of 1889 days. The median stent patency and survival times were 470 and 1783 days, respectively. The only independent risk factor for stent dysfunction was portal trunk (right, left, or main portal trunk) access (P = 0.006). The median stent patency with segmental branch access (538 days) was significantly longer than that with portal trunk access (245 days) (P = 0.007). There were no significant differences in patient survival (P = 0.648), worsening of encephalopathy (P = .0742), or major complications (P = 1.000). Conclusion: TIPS created with segmental portal venous access has superior patency over that of TIPS with portal trunk access. However, we found no significant difference in patient survival, worsening of encephalopathy, or major complications between segmental access and portal trunk access.

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“…Die Stentdysfunktion ist eine der häufigsten Komplikationen im Therapieverlauf nach TIPSImplantation (Barrio et al 2005, Boyer et al 2005 (Bilbao et al 2002). Andere Studien hatten Stenoseraten der implantierten Stents zwischen 22 % und 60 % (Crenshaw et al 1996, Nazarian et al 1997, Ochs et al 1995.…”

Section: Revisionenunclassified

Verlaufsbeobachtung von Patienten mit Anlage eines Transjugulären Intrahepatischen Portosystemischen Shunts (TIPS) zur Beeinflussung des Aszites bei dekompensierter Leberzirrhose

Ballauf¹,

Holle²,

Emmrich³

et al. 2009

Z Gastroenterol

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Comparison of transjugular intrahepatic portosystemic shunt dysfunction in PTFE-covered stent-grafts versus bare stents

Cited by 97 publications

References 23 publications

Consensus conference on TIPS management: Techniques, indications, contraindications

Consensus conference on TIPS management: Techniques, indications, contraindications

Stent Dysfunction After Transjugular Intrahepatic Portosystemic Shunt: A 14-Year Experience from a Single Tertiary Medical Center

Verlaufsbeobachtung von Patienten mit Anlage eines Transjugulären Intrahepatischen Portosystemischen Shunts (TIPS) zur Beeinflussung des Aszites bei dekompensierter Leberzirrhose

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