Stent-grafts in transjugular intrahepatic portosystemic shunts

Jian Bo Zhao, Yan Hao Li, Kenneth Kolbeck, Frederick Keller, John Kaufman, Robert Barton, Bryan Petersen

Research output: Contribution to journalArticle

Abstract

Objective: To retrospectively evaluate the efficacy of polytetrafluorothylene covered nitinol stent graft (Viatorr, Gore, Flagstaff Arizona, USA) in transjugular intrahepatic portosystemic shunt (TIPS). Methods: Thirty-seven consecutive patients underwent a TIPS procedure between May 2004 and June 2006 at the Dotter Interventional Institute in Portland, Oregon, USA. The average follow-up time was (15.2 ± 9.3) months. Indications for the procedure included recurrent variceal bleeding after attempted endoscopic management (n = 17), refractory ascites or hydrothorax (n = 18), and Budd-Chiari syndrome (n = 2). The t test was used for statistics. Results: Forty-one stent-grafts were implanted in 37 patients, 3 of the devices were 8 mm in diameter and 38 were 10 mm. The covered stent length varied from 4 to 8 cm without complications. Portosystemic gradient (PSG) decresed significantly from (22.4 ± 8.4) mm Hg (1 mm Hg = 0.133 kPa) to (8.1 ± 3.2) mm Hg, (t = 12.754, P <0.01). During the follow-up period, Variceal bleeding recurrence occurred in 1 of 17 patients and for ascites or hydrothorax, two of 14 patients. Shunt occlusion occurred in 2 of 37 (5.4%) patients (4 and 17 months post-shunt). The 1-year primary patency rate was 97.0%. Two patients died from multisystem organ failure (MSOF) with a patent stent-graft during the follow-up period. Five patients were excluded from the evaluation after liver transplantation. Conclusion: TIPS created with a PTFE-covered stent (Viatorr) showed favorable patency rate and low complication rates.

Original languageEnglish (US)
Pages (from-to)830-834
Number of pages5
JournalChinese Journal of Radiology
Volume42
Issue number8
StatePublished - Aug 2008
Externally publishedYes

Fingerprint

Transjugular Intrahepatic Portasystemic Shunt
Stents
Transplants
Hydrothorax
Ascites
Hemorrhage
Budd-Chiari Syndrome
Polytetrafluoroethylene
Liver Transplantation
Recurrence
Equipment and Supplies

Keywords

  • Hypertension, portal
  • Radiology, interventional
  • Stents

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Stent-grafts in transjugular intrahepatic portosystemic shunts. / Zhao, Jian Bo; Li, Yan Hao; Kolbeck, Kenneth; Keller, Frederick; Kaufman, John; Barton, Robert; Petersen, Bryan.

In: Chinese Journal of Radiology, Vol. 42, No. 8, 08.2008, p. 830-834.

Research output: Contribution to journalArticle

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title = "Stent-grafts in transjugular intrahepatic portosystemic shunts",
abstract = "Objective: To retrospectively evaluate the efficacy of polytetrafluorothylene covered nitinol stent graft (Viatorr, Gore, Flagstaff Arizona, USA) in transjugular intrahepatic portosystemic shunt (TIPS). Methods: Thirty-seven consecutive patients underwent a TIPS procedure between May 2004 and June 2006 at the Dotter Interventional Institute in Portland, Oregon, USA. The average follow-up time was (15.2 ± 9.3) months. Indications for the procedure included recurrent variceal bleeding after attempted endoscopic management (n = 17), refractory ascites or hydrothorax (n = 18), and Budd-Chiari syndrome (n = 2). The t test was used for statistics. Results: Forty-one stent-grafts were implanted in 37 patients, 3 of the devices were 8 mm in diameter and 38 were 10 mm. The covered stent length varied from 4 to 8 cm without complications. Portosystemic gradient (PSG) decresed significantly from (22.4 ± 8.4) mm Hg (1 mm Hg = 0.133 kPa) to (8.1 ± 3.2) mm Hg, (t = 12.754, P <0.01). During the follow-up period, Variceal bleeding recurrence occurred in 1 of 17 patients and for ascites or hydrothorax, two of 14 patients. Shunt occlusion occurred in 2 of 37 (5.4{\%}) patients (4 and 17 months post-shunt). The 1-year primary patency rate was 97.0{\%}. Two patients died from multisystem organ failure (MSOF) with a patent stent-graft during the follow-up period. Five patients were excluded from the evaluation after liver transplantation. Conclusion: TIPS created with a PTFE-covered stent (Viatorr) showed favorable patency rate and low complication rates.",
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AU - Zhao, Jian Bo

AU - Li, Yan Hao

AU - Kolbeck, Kenneth

AU - Keller, Frederick

AU - Kaufman, John

AU - Barton, Robert

AU - Petersen, Bryan

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N2 - Objective: To retrospectively evaluate the efficacy of polytetrafluorothylene covered nitinol stent graft (Viatorr, Gore, Flagstaff Arizona, USA) in transjugular intrahepatic portosystemic shunt (TIPS). Methods: Thirty-seven consecutive patients underwent a TIPS procedure between May 2004 and June 2006 at the Dotter Interventional Institute in Portland, Oregon, USA. The average follow-up time was (15.2 ± 9.3) months. Indications for the procedure included recurrent variceal bleeding after attempted endoscopic management (n = 17), refractory ascites or hydrothorax (n = 18), and Budd-Chiari syndrome (n = 2). The t test was used for statistics. Results: Forty-one stent-grafts were implanted in 37 patients, 3 of the devices were 8 mm in diameter and 38 were 10 mm. The covered stent length varied from 4 to 8 cm without complications. Portosystemic gradient (PSG) decresed significantly from (22.4 ± 8.4) mm Hg (1 mm Hg = 0.133 kPa) to (8.1 ± 3.2) mm Hg, (t = 12.754, P <0.01). During the follow-up period, Variceal bleeding recurrence occurred in 1 of 17 patients and for ascites or hydrothorax, two of 14 patients. Shunt occlusion occurred in 2 of 37 (5.4%) patients (4 and 17 months post-shunt). The 1-year primary patency rate was 97.0%. Two patients died from multisystem organ failure (MSOF) with a patent stent-graft during the follow-up period. Five patients were excluded from the evaluation after liver transplantation. Conclusion: TIPS created with a PTFE-covered stent (Viatorr) showed favorable patency rate and low complication rates.

AB - Objective: To retrospectively evaluate the efficacy of polytetrafluorothylene covered nitinol stent graft (Viatorr, Gore, Flagstaff Arizona, USA) in transjugular intrahepatic portosystemic shunt (TIPS). Methods: Thirty-seven consecutive patients underwent a TIPS procedure between May 2004 and June 2006 at the Dotter Interventional Institute in Portland, Oregon, USA. The average follow-up time was (15.2 ± 9.3) months. Indications for the procedure included recurrent variceal bleeding after attempted endoscopic management (n = 17), refractory ascites or hydrothorax (n = 18), and Budd-Chiari syndrome (n = 2). The t test was used for statistics. Results: Forty-one stent-grafts were implanted in 37 patients, 3 of the devices were 8 mm in diameter and 38 were 10 mm. The covered stent length varied from 4 to 8 cm without complications. Portosystemic gradient (PSG) decresed significantly from (22.4 ± 8.4) mm Hg (1 mm Hg = 0.133 kPa) to (8.1 ± 3.2) mm Hg, (t = 12.754, P <0.01). During the follow-up period, Variceal bleeding recurrence occurred in 1 of 17 patients and for ascites or hydrothorax, two of 14 patients. Shunt occlusion occurred in 2 of 37 (5.4%) patients (4 and 17 months post-shunt). The 1-year primary patency rate was 97.0%. Two patients died from multisystem organ failure (MSOF) with a patent stent-graft during the follow-up period. Five patients were excluded from the evaluation after liver transplantation. Conclusion: TIPS created with a PTFE-covered stent (Viatorr) showed favorable patency rate and low complication rates.

KW - Hypertension, portal

KW - Radiology, interventional

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