Abstract | BACKGROUND: AIM: To assess the effectiveness and optimal candidate selection for embolisation of SPSS, for the treatment of recurrent HE in patients with cirrhosis. METHODS: This retrospective cohort study compared 17 patients with recurrent HE who achieved complete occlusion of SPSS by angiographic embolisation and 17 control patients. RESULTS: Most baseline characteristics were similar in the two groups. The 2-year HE recurrence rate was significantly lower in the embolisation than in the control group (39.9% vs. 79.9%, P = 0.02), whereas their 2-year overall survival rates were similar (64.7% vs. 53.4%, P = 0.98). Model for end-stage liver disease (MELD) and Child-Turcotte-Pugh ( CTP) score were significant predictors of 2-year patient mortality in the embolisation group. Analysis of patients with MELD <15 in the absence of hepatocellular carcinoma (HCC) showed that 2-year overall survival rate was significantly higher in the embolisation group than in the control group (100% vs. 60%, P = 0.03). The median changes in MELD (-1.6 vs. 2.5, P < 0.01), CTP score (-3 vs. 0, P < 0.01), and liver volume (61 mL vs. -117 mL; P = 0.046) at 1 year significantly favoured the embolisation group. Serious clinical complications after embolisation occurred only in patients who had MELD ≥15 and/or HCC at baseline, with all six dying within 1 year. CONCLUSIONS:
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Authors | J An, K W Kim, S Han, J Lee, Y-S Lim |
Journal | Alimentary pharmacology & therapeutics
(Aliment Pharmacol Ther)
Vol. 39
Issue 12
Pg. 1418-26
(Jun 2014)
ISSN: 1365-2036 [Electronic] England |
PMID | 24754260
(Publication Type: Journal Article)
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Copyright | © 2014 John Wiley & Sons Ltd. |
Topics |
- Aged
- Cohort Studies
- Embolization, Therapeutic
- End Stage Liver Disease
(complications, epidemiology, surgery)
- Female
- Hepatic Encephalopathy
(epidemiology, etiology, prevention & control)
- Humans
- Liver Cirrhosis
(complications, epidemiology, surgery)
- Male
- Middle Aged
- Retrospective Studies
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