Influence of the Secondary Deployment of Expanded Polytetrafluoroethylene–covered Stent Grafts on Maintenance of Transjugular Intrahepatic Portosystemic Shunt Patency

Jirkovský, Václav; Fejfar, Tomáš; Šafka, Václav; Hůlek, P; Krajina, Antonı́n; Chovanec, Vendelı́n; Raupach, Jan; Lojík, Miroslav; Vaňásek, Tomáš; Renc, Ondřej; Ali, Shahzad

doi:10.1016/j.jvir.2010.09.016

Cited by 27 publications

(15 citation statements)

References 21 publications

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“…If the original TIPS was created using a bare-metal stent, placement of a covered stent is likely to improve long-term shunt patency [68]. Other commonly used measures include balloon angioplasty within the stents and the placement of additional stents in patients to extend cranial or caudal length of the stent.…”

Section: Follow-upmentioning

confidence: 99%

Transjugular intrahepatic portosystemic shunt for acute variceal gastrointestinal bleeding: Indications, techniques and outcomes

Loffroy

Favelier

Pottecher

et al. 2015

Diagnostic and Interventional Imaging

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Acute variceal bleeding is a life-threatening condition that requires a multidisciplinary approach for effective therapy. The transjugular intrahepatic portosystemic shunt (TIPS) procedure is a minimally invasive image-guided intervention used for secondary prevention of bleeding and as salvage therapy in acute bleeding. Emergency TIPS should be considered early in patients with refractory variceal bleeding once medical treatment and endoscopic sclerotherapy fail, before the clinical condition worsens. Furthermore, admission to specialized centers is mandatory in such a setting and regional protocols are essential to be organized effectively. This procedure involves establishment of a direct pathway between the hepatic veins and the portal veins to decompress the portal venous hypertension that is the source of the patient's bleeding. The procedure is technically challenging, especially in critically ill patients, and has a mortality of 30%-50% in the emergency setting, but has an effectiveness greater than 90% in controlling bleeding from gastro-esophageal varices. This review focuses on the role of TIPS in the setting of variceal bleeding, with emphasis on current indications and techniques for TIPS creation, TIPS clinical outcomes, and the role of adjuvant embolization of varices.

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Section: Follow-upmentioning

confidence: 99%

Transjugular intrahepatic portosystemic shunt for acute variceal gastrointestinal bleeding: Indications, techniques and outcomes

Loffroy

Favelier

Pottecher

et al. 2015

Diagnostic and Interventional Imaging

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“…Saxon et al [26] reported that stenting to revise stenoses often led to durable results but that all of the stenoses treated with angioplasty alone recurred. Similarly, in a recent study, stenting for shunt revision led to significantly better patency than angioplasty alone [27].…”

Section: Managing Tips Dysfunctionmentioning

confidence: 87%

Evaluation and Management of Transjugular Intrahepatic Portosystemic Shunts

Darcy

2012

American Journal of Roentgenology

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“…It has been shown that the use of the Viatorr ® stents for TIPS results in a markedly prolonged shunt patency up to 76% at 2 years versus 8% to 48% at 2 years for TIPS created with bare metal stents (30,31). Early and late shunt dysfunction must be differentiated.…”

Section: Discussionmentioning

confidence: 99%

Persistence of gastric or esophageal varices on final angiography increases transjugular intrahepatic portosystemic shunt revision rate after polytetrafluoroethylene-covered stent shunt creation

Moulin¹,

Chevallier²,

Abdulmalak³

et al. 2018

Quant. Imaging Med. Surg.

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Background: To assess the association between final polytetrafluoroethylene (PTFE)-covered stent transjugular intrahepatic portosystemic shunt (TIPS) angiographic parameters and free shunt revision survey. Results: Mean follow-up was 455 days. Thirteen (19.4%) patients had shunt revision. Significant free shunt revision survey difference was found between post-procedural angiographic persistent varices group and the group without varices (P=0.0001). Shunt revision rate at 3, 12 and 24 months was respectively 13%, 29%, and 39% in the group with varices versus 0%, 2.7% and 2.7% in the group without. No difference was found between groups for angles A, B, C and distance D.Conclusions: Persistence of gastric or esophageal varices on final trans-TIPS angiography increases TIPS revision rate after PTFE-covered stent shunt creation whereas geometric parameters have no influence.

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Influence of the Secondary Deployment of Expanded Polytetrafluoroethylene–covered Stent Grafts on Maintenance of Transjugular Intrahepatic Portosystemic Shunt Patency

Cited by 27 publications

References 21 publications

Transjugular intrahepatic portosystemic shunt for acute variceal gastrointestinal bleeding: Indications, techniques and outcomes

Transjugular intrahepatic portosystemic shunt for acute variceal gastrointestinal bleeding: Indications, techniques and outcomes

Evaluation and Management of Transjugular Intrahepatic Portosystemic Shunts

Persistence of gastric or esophageal varices on final angiography increases transjugular intrahepatic portosystemic shunt revision rate after polytetrafluoroethylene-covered stent shunt creation

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