Xiaoze Wang1, Yongjun Zhu2, Ming Zhu1, Xuefeng Luo1, Li Yang1. 1. Department of Gastroenterology and Hepatology, Sichuan University-University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer, West China Hospital, Sichuan University, Chengdu, China. 2. Department of Gastroenterology and Hepatology, Second Affiliated Hospital of Chongqing Medical Univeristy, Chongqing, China.
Abstract
PURPOSE: We aimed to determine the technical feasibility, safety and prognosis of the transjugular intrahepatic portosystemic shunt (TIPS) revision by combined Y-configured stents placement. METHODS: We retrospectively evaluated 12 patients who received TIPS revision using Y-stenting technique between June 2015 and January 2019. The rates of technical success, complication, shunt patency, hepatic encephalopathy and mortality were described and analyzed. RESULTS: The combined Y-configured stents were successfully placed in 11 of 12 patients (92%) without major complications. The median portosystemic pressure gradient (PPG) decreased from 23 mmHg (interquartile range, IQR, 18.5-27.5 mmHg) to 10 mmHg (IQR, 9-14 mmHg). The left internal jugular vein approach was used in 5 patients. Four patients required a shunt extension with an extra stent to resolve the stenosis at the portal venous terminus. Two patients developed hepatic encephalopathy, which was medically controlled within 3 months after the procedure. The TIPS patency and survival rates were both 100% during a median follow-up period of 10 months (IQR, 5.5-14 months). CONCLUSION: TIPS revision by combined Y-configured stents placement was technically feasible and safe with favorable clinical outcomes.
PURPOSE: We aimed to determine the technical feasibility, safety and prognosis of the transjugular intrahepatic portosystemic shunt (TIPS) revision by combined Y-configured stents placement. METHODS: We retrospectively evaluated 12 patients who received TIPS revision using Y-stenting technique between June 2015 and January 2019. The rates of technical success, complication, shunt patency, hepatic encephalopathy and mortality were described and analyzed. RESULTS: The combined Y-configured stents were successfully placed in 11 of 12 patients (92%) without major complications. The median portosystemic pressure gradient (PPG) decreased from 23 mmHg (interquartile range, IQR, 18.5-27.5 mmHg) to 10 mmHg (IQR, 9-14 mmHg). The left internal jugular vein approach was used in 5 patients. Four patients required a shunt extension with an extra stent to resolve the stenosis at the portal venous terminus. Two patients developed hepatic encephalopathy, which was medically controlled within 3 months after the procedure. The TIPS patency and survival rates were both 100% during a median follow-up period of 10 months (IQR, 5.5-14 months). CONCLUSION: TIPS revision by combined Y-configured stents placement was technically feasible and safe with favorable clinical outcomes.
Authors: Sean R Dariushnia; Ziv J Haskal; Mehran Midia; Louis G Martin; T Gregory Walker; Sanjeeva P Kalva; Timothy W I Clark; Suvranu Ganguli; Venkataramu Krishnamurthy; Cindy K Saiter; Boris Nikolic Journal: J Vasc Interv Radiol Date: 2015-11-21 Impact factor: 3.464
Authors: Charles N Weber; Gregory J Nadolski; Sarah B White; Timothy W I Clark; Jeffrey I Mondschein; S William Stavropoulos; Richard D Shlansky-Goldberg; Scott O Trerotola; Michael C Soulen Journal: J Vasc Interv Radiol Date: 2015-05-16 Impact factor: 3.464