PURPOSE: To evaluate the outcome of transjugular intrahepatic portosystemic shunt (TIPS) in patients with Budd-Chiari syndrome (BCS). PATIENTS AND METHODS: Fourteen patients (11 female, mean age 45.8 years), with symptomatic BCS refractory to conventional therapy, were treated with TIPS placement in our department within a period of 9 years. Stent grafts were primarily used in 12 patients. Mean follow-up time was 38.1 ± 36.1 months (range 7-114). Model for end-stage liver disease (MELD) score, BCS Rotterdam index, and Child-Pugh score were calculated for all patients. In addition, the recently suggested BCS-TIPS prognostic index score (BSC-TIPS PI) was applied. RESULTS: BCS-TIPS PI score was ≤7 in all patients. Most of our patients (12 of 14) had good or intermediate prognosis according to MELD, Rotterdam and Child-Pugh scores. Technical success was achieved in all 14 patients and was accompanied by complete resolution of the symptoms. In 3 patients, the procedure was complicated by hemoperitoneum, which was successfully treated in two patients with coils or stent-graft placement, whereas 1 patient was managed in the operating room. Thirteen patients are symptom and orthotopic liver transplantation-free. Primary patency was 92.8, 84.7, and 58.7 % at 6, 12, and 24 months, respectively. Secondary patency was 100, 100 and 84.6 % at 6, 12, and 24 months respectively. CONCLUSION: In symptomatic BCS patients with moderate prognosis according to MELD, Child-Pugh, and BCS Rotterdam scores, as well as BCS-TIPS PI score ≤7, TIPS has high clinical success, low morbidity, and no mortality, and it offers durable mid-term resolution of the symptoms and OLT-free survival.
PURPOSE: To evaluate the outcome of transjugular intrahepatic portosystemic shunt (TIPS) in patients with Budd-Chiari syndrome (BCS). PATIENTS AND METHODS: Fourteen patients (11 female, mean age 45.8 years), with symptomatic BCS refractory to conventional therapy, were treated with TIPS placement in our department within a period of 9 years. Stent grafts were primarily used in 12 patients. Mean follow-up time was 38.1 ± 36.1 months (range 7-114). Model for end-stage liver disease (MELD) score, BCS Rotterdam index, and Child-Pugh score were calculated for all patients. In addition, the recently suggested BCS-TIPS prognostic index score (BSC-TIPS PI) was applied. RESULTS: BCS-TIPS PI score was ≤7 in all patients. Most of our patients (12 of 14) had good or intermediate prognosis according to MELD, Rotterdam and Child-Pugh scores. Technical success was achieved in all 14 patients and was accompanied by complete resolution of the symptoms. In 3 patients, the procedure was complicated by hemoperitoneum, which was successfully treated in two patients with coils or stent-graft placement, whereas 1 patient was managed in the operating room. Thirteen patients are symptom and orthotopic liver transplantation-free. Primary patency was 92.8, 84.7, and 58.7 % at 6, 12, and 24 months, respectively. Secondary patency was 100, 100 and 84.6 % at 6, 12, and 24 months respectively. CONCLUSION: In symptomatic BCS patients with moderate prognosis according to MELD, Child-Pugh, and BCS Rotterdam scores, as well as BCS-TIPS PI score ≤7, TIPS has high clinical success, low morbidity, and no mortality, and it offers durable mid-term resolution of the symptoms and OLT-free survival.
Authors: Mohammad Sakr; Sara M Abdelhakam; Soheir A Elsayed; Enas H Allam; Amir M Farid; Waleed Abdelmoaty; Azza M Hassan; Mohamed Shaker; Mohamed El-Gharib; Ahmed Eldorry Journal: World J Gastroenterol Date: 2017-01-28 Impact factor: 5.742
Authors: Thomas Reiberger; Andreas Püspök; Maria Schoder; Franziska Baumann-Durchschein; Theresa Bucsics; Christian Datz; Werner Dolak; Arnulf Ferlitsch; Armin Finkenstedt; Ivo Graziadei; Stephanie Hametner; Franz Karnel; Elisabeth Krones; Andreas Maieron; Mattias Mandorfer; Markus Peck-Radosavljevic; Florian Rainer; Philipp Schwabl; Vanessa Stadlbauer; Rudolf Stauber; Herbert Tilg; Michael Trauner; Heinz Zoller; Rainer Schöfl; Peter Fickert Journal: Wien Klin Wochenschr Date: 2017-10-23 Impact factor: 1.704