Comparison of the Covered Self-Expandable Viatorr CX Stent with the Covered Balloon-Expandable BeGraft Peripheral Stent for Transjugular Intrahepatic Portosystemic Shunt (TIPS) Creation: a Single-Centre Retrospective Study in Patients with Variceal Bleeding

Schultheiß, Michael; Bettinger, Dominik; Sturm, Lukas; Schmidt, Arthur; Backhus, J; Waidmann, Oliver; Radecke, K.; Grandt, Daniel; Thimme, Robert; Rössle, Martin

doi:10.1007/s00270-021-03040-8

Cited by 8 publications

(4 citation statements)

References 39 publications

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“…However, as the older generation VIATORR was a commonly used and clinically well-known stent, understanding of how the new VCX compares to the previous VIATORR version in vitro, may help clinicians to better predict its behavior in situ. More relevant would also be the comparison between VCX and the balloon-expandable stents recently used instead of VIATORR [ 18 , 19 ]. However, this is not possible because the test method used is only suitable for nitinol stents.…”

Section: Discussionmentioning

confidence: 99%

How Controlled is the Expansion of VIATORR CX?

Dell

Menne

Wagenpfeil

et al. 2023

Cardiovasc Intervent Radiol

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Purpose To investigate and compare the physical properties of the new generation Gore VIATORR-Controlled Expansion Endoprosthesis (VCX) to those of the predecessor VIATORR stent in an in vitro experimental setup. Materials and Methods A total of 12 stents (8 VCX; 4 VIATORR; GORE, USA) were examined. Radial resistive force (RRF) and chronic outward force (COF) were assessed using a radial force testing machine (RX-650, Machine Solutions Inc., USA). To assess the radial forces of the VCX above 8 mm, balloon expansion was performed between cycles. Results All VCX stents show an abrupt decrease in COF at an external diameter of 8.3 mm; RRF decreases likewise at an external diameter of 8.5 mm. The predecessor VIATORR stent without the “controlled expansion” feature shows linear radial force reduction until full expansion at a diameter of 10 mm. The physical properties of the VCX can be altered by balloon modulation. Point of COF (RRF) reduction shifts to 8.5 mm (8.6 mm), 8.6 mm (8.8 mm) and 9.3 mm (9.6 mm) following modulation with a 8 mm, 9 mm and 10 mm balloon. Conclusions The VCX shows an abrupt and disproportionate decrease in COF and RRF at an external diameter of 8.3 mm, thus passive expansion to its nominal diameter of 10 mm is not to be expected. By means of balloon dilatation the physical properties of the stent can be altered, enabling customized TIPS creation. The previous VIATORR stent shows continuous COF and RRF until total expansion.

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Section: Discussionmentioning

confidence: 99%

How Controlled is the Expansion of VIATORR CX?

Dell

Menne

Wagenpfeil

et al. 2023

Cardiovasc Intervent Radiol

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“…Procedural complications during TIPS are rare (<5%) in contemporary series 45,46 but may include intraperitoneal bleeding, arterial injury, liver infarct, hepatic capsular puncture, hemobilia, immediate TIPS thrombosis, and sepsis 47,48 . Procedure-related deaths occur in <1% 46 …”

Section: Tipsmentioning

confidence: 99%

“…[47,48] Procedure-related deaths occur in <1%. [46] The most relevant long-term complications are those related to shunting, mainly hepatic encephalopathy, deterioration in liver function, and complications related to cardiac overload (Table 3).…”

Section: Complicationsmentioning

confidence: 99%

AASLD Practice Guidance on the use of TIPS, variceal embolization, and retrograde transvenous obliteration in the management of variceal hemorrhage

et al. 2023

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This is a comprehensive guidance on the use of interventional radiology endovascular techniques in the management of variceal hemorrhage from the American Association for the Study of Liver Diseases (AASLD). This guidance document is complementary to the AASLD "Risk Stratification and Management of Portal Hypertension and Varices in Cirrhosis" guidance [1] and addresses the recent advancements in these invasive procedures. Although the use of TIPS dates back to the 1980s, several new technical refinements in TIPS stents have occurred in the last few years. The other major addition to the management of gastric variceal hemorrhage in North America has been the introduction of retrograde transvenous obliteration (RTO) in its different forms. The present document aims to equip care providers with an in-depth understanding of the use of TIPS and/or variceal embolization/obliteration in the management of variceal hemorrhage. The goal is to facilitate multidisciplinary discussions between hepatologists, gastroenterologists, interventional radiologists, and surgeons in the

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“…The initially used bare metal stents were fraught with early occlusions and have been largely replaced by hybrid self-expanding metallic stent grafts, which combine covered and uncovered portions 8 . The original 8 or 10 mm Viatorr TIPS stent graft (Gore, Flagstaff, Arizona) has recently been replaced by the variable (8 – 10 mm) diameter Viatorr CX graft, 9 which allows the procedurist to adjust the diameter to 8, 9, or 10 mm depending on the desired pressure gradient. The advancing liver therapeutic approaches consortium provides multidisciplinary evidence-based recommendations for TIPS 1 …”

Section: Introductionmentioning

confidence: 99%

IR management of portal hypertension complications

Gogna,

Tan,

Too

et al. 2023

Clinical Liver Disease

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Comparison of the Covered Self-Expandable Viatorr CX Stent with the Covered Balloon-Expandable BeGraft Peripheral Stent for Transjugular Intrahepatic Portosystemic Shunt (TIPS) Creation: a Single-Centre Retrospective Study in Patients with Variceal Bleeding

Cited by 8 publications

References 39 publications

How Controlled is the Expansion of VIATORR CX?

How Controlled is the Expansion of VIATORR CX?

AASLD Practice Guidance on the use of TIPS, variceal embolization, and retrograde transvenous obliteration in the management of variceal hemorrhage

IR management of portal hypertension complications

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