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Transjugular intrahepatic portosystemic shunts using the Wallstent prosthesis: a follow-up study.

AbstractPURPOSE:
The aim of the present study was to assess the efficacy of transjugular intrahepatic portosystemic shunts (TIPS) in 45 patients with cirrhosis during a mean follow-up of 7 months.
METHODS:
Forty-five consecutive patients treated by TIPS and who had been followed for at least 6 months after TIPS or until death, were included. Mean follow-up was 7.2 +/- 5.0 months. Shunt patency was assessed at 1 week and 1 month, then every 3 months after the procedure by Doppler US and angiography whenever needed.
RESULTS:
Thirty-six patients had been stented for refractory bleeding from ruptured esophagogastric varices. Of these, 8 patients (22%) rebled, 7 of whom were treated by a second shunt. Nine patients were treated for refractory ascites. Three patients had recurrent ascites due to shunt obstruction. All were treated by a second shunt which occluded in 2 patients. As a whole, 14 (31.1%) patients developed shunt obstruction within a mean of 120 +/- 136 days, 4 of whom remained asymptomatic. Other complications were septicemia by Staphylococcus aureus in 1 patient, transient encephalopathy in 9 patients, and disseminated intravascular coagulation in 1 patient.
CONCLUSIONS:
TIPS appears to be a relatively safe and effective technique in treating complications of portal hypertension in patients with cirrhosis. Shunt obstruction in 31% of our patients probably represents the most important limitation of this technique.
AuthorsH Rousseau, J P Vinel, J I Bilbao, J M Longo, P Maquin, J M Zozaya, L Garcia-Villareal, B Coustet, N Railhac, J J Railhac
JournalCardiovascular and interventional radiology (Cardiovasc Intervent Radiol) 1994 Jan-Feb Vol. 17 Issue 1 Pg. 7-11 ISSN: 0174-1551 [Print] United States
PMID8187135 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Ascites (etiology, surgery)
  • Esophageal and Gastric Varices (etiology)
  • Follow-Up Studies
  • Gastrointestinal Hemorrhage (etiology)
  • Humans
  • Hypertension, Portal (complications, surgery)
  • Liver Cirrhosis (complications)
  • Middle Aged
  • Portasystemic Shunt, Surgical (methods, mortality)
  • Stents
  • Survival Rate

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