Expanded polytetrafluoroethylene (ePTFE)-covered stents versus bare stents for transjugular intrahepatic portosystemic shunt in people with liver cirrhosis

Li, Tong; Sun, Ping; Belgaumkar, Ajay; Sun, Yi; Cheng, Xiang; Zheng, Qichang

doi:10.1002/14651858.cd012358

Cited by 3 publications

(2 citation statements)

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“…The mainly used are abdominal aortic aneurysm and thoracic stents grafts, but stents for coronary artery or femoropopliteal atherosclerotic lesions can also be encountered. They are also found for transjugular intrahepatic portosystemic shunt 19‐23 …”

Section: Clinical Trial Of Eptfe Medical Devicesmentioning

confidence: 85%

ePTFE‐based biomedical devices: An overview of surgical efficiency

et al. 2021

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Polytetrafluoroethylene (PTFE) is a ubiquitous material used for implants and medical devices in general because of its high biocompatibility and inertness: blood vessel, heart, table jawbone, nose, eyes, or abdominal wall can benefit from its properties in case of disease or injury. Its expanded version, ePTFE is an improved version of PTFE with better mechanical properties, which extends its medical applications. A material as frequently used as ePTFE with these exceptional properties deserves a review of its main uses, developments, and possibility of improvements. In this systematic review, we examined clinical trials related to ePTFE‐based medical devices from the literature. Then, we excluded all trials using ePTFE as a control to test other devices. ePTFE‐coated stents, hemodialysis and bypass grafts, guided bone and tissue regeneration membranes, hernia and heart repair and other devices are reviewed. The rates of success using these devices and their efficiency compared to other materials used for the same purposes are reported. ePTFE appears to be more or just as efficient compared to them. Some success rates remain low, suggesting the need of improvement ePTFE for medical applications.

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Section: Clinical Trial Of Eptfe Medical Devicesmentioning

confidence: 85%

ePTFE‐based biomedical devices: An overview of surgical efficiency

et al. 2021

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“…Hepatic encephalopathy and deteriorating liver function are the most common adverse events after TIPS, and both are linked to a decrease in blood perfusion in the liver due to shunt formation [3]. The introduction of polytetrafluoroethylenecovered stents, which are not linked to an increased risk of HE as compared to bare stents, has dramatically reduced the rate of shunt malfunction [4]. After TIPS, 35-50% of patients experience an episode of overt HE [5].…”

Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Treatment Options for the Prevention of Post-TIPS Hepatic Encephalopathy: A Systematic Review and Network Meta-analysis

Ahmed

Hassan

Arif

et al. 2023

JGLD

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Background and Aims: Transjugular intrahepatic portosystemic shunt (TIPS) is often used in patients with cirrhosis to manage portal hypertension-related complications. Unfortunately, 35-50% of patients develop overt hepatic encephalopathy (HE) after TIPS. However, data on lactulose and rifaximin to prevent post-TIPS HE is limited. Therefore, we aimed to perform a network meta-analysis to investigate the efficacy of multiple pharmacological regimens in the prevention of post-TIPS HE. Methods: A comprehensive search strategy to identify reports of studies of rifaximin use on post-TIPS hepatic encephalopathy was constructed using truncated keywords, phrases, and subject headings developed in Embase. This strategy was translated to MEDLINE, Cochrane Central Register of Controlled Trials, and the Web of Science Core Collection, with all searches performed on 10 February 2022. No publication date or language limits were used. Results: The initial search identified 72 studies, and 56 studies were screened after removing duplicates. Five studies, two randomized controlled trials (RCTs) and three retrospective studies, met our inclusion criteria and were included in the final analysis. A total of 840 patients were included, with 65% male. Our meta- analysis did not find a statistically significant difference between lactulose vs placebo/no prophylaxis, nor rifaximin vs placebo/no prophylaxis, nor rifaximin plus lactulose vs placebo/no prophylaxis in the reduction of post-TIPS HE. Conclusions: Rifaximin alone, lactulose alone, and rifaximin plus lactulose did not significantly reduce the development of post-TIPS HE. Based on the P-scores of the three treatment groups, the combination of rifaximin plus lactulose showed the most promising trend towards preventing post-TIPS HE. More studies, especially large RCTs, are warranted.

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