TIPS: comparison of shunt patency and clinical outcomes between bare stents and expanded polytetrafluoroethylene stent-grafts

J Vasc Interv Radiol. 2009 Feb;20(2):180-5. doi: 10.1016/j.jvir.2008.11.005. Epub 2008 Dec 18.

Abstract

Purpose: To compare shunt patency and clinical outcomes in two groups of patients who received a transjugular intrahepatic portosystemic shunt (TIPS): one group with bare stents and one with expanded polytetrafluoroethylene stent-grafts.

Materials and methods: TIPS were created with bare stents (n = 41) or stent-grafts (n = 40). Overall TIPS patency rates were compared between these two groups, as were clinical outcomes in patients with variceal bleeding and those with ascites.

Results: In the bare stent group, primary shunt patency rates were 63%, 48%, and 24% at 3, 6, and 12 months, respectively. Secondary patency rates were 75% and 62% at 3 and 6 months, respectively. In the stent-graft group, primary patency rates were 94%, 67%, and 38% at 3, 6, and 12 months, respectively. Secondary patency rates were 100% and 92% at 3 and 6 months, respectively. All stent patency rates were higher in the stent-graft group, but only the difference in the 3-month primary patency rate (63% vs 94%) reached significance (P = .03). In patients with variceal bleeding as well as those with ascites, early and overall clinical success rates were higher in the stent-graft group, but only the 3-month and 12-month differences were statistically significant.

Conclusions: TIPS created with stent-grafts had better 3-month primary patency rates and better 3-month and 12-month clinical success rates compared with those created with bare stents.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Vessel Prosthesis
  • Equipment Failure Analysis
  • Female
  • Fluorocarbon Polymers*
  • Humans
  • Hypertension, Portal / surgery*
  • Male
  • Middle Aged
  • Portasystemic Shunt, Transjugular Intrahepatic / instrumentation*
  • Portasystemic Shunt, Transjugular Intrahepatic / methods
  • Prosthesis Design
  • Prosthesis Failure
  • Stents*
  • Treatment Outcome
  • Vascular Patency*

Substances

  • Fluorocarbon Polymers
  • polytetrafluoroethane