Document Detail


Dacron-covered stent-grafts in transjugular intrahepatic portosystemic shunts: initial experience.
MedLine Citation:
PMID:  16000648     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To retrospectively review the authors' experience with use of a Dacron-covered stent-graft in transjugular intrahepatic postosystemic shunts (TIPS). MATERIALS AND METHODS: The need for internal review board approval was waived. Informed consent was obtained from all patients. The study was compliant with the Health Insurance Portability and Accountability Act. A retrospective analysis was performed of 16 patients who received a Dacron-covered stent-graft during revision or de novo creation of TIPS. There were 13 men and three women aged 44-80 years (mean age, 61 years). Primary unassisted and assisted patency rates and secondary patency rates were estimated. The primary unassisted patency of patients who underwent de novo placement of stent-grafts (n = 10) was compared with that of patients with stent-grafts placed during shunt revision (n = 6); in all patients, stent-grafts were placed within stents. Primary unassisted patency was also compared between patients in whom the covered stent was confined to the parenchymal tract (n = 7) and those in whom the stent extended 1 cm or more into the portal vein (n = 9). Patency was estimated with the Kaplan-Meier method, and group comparisons were performed with the log-rank test. RESULTS: Primary unassisted patency rates following stent-graft placement at 4, 12, and 24 months (+/- standard error) were 64% +/- 14, 54% +/- 15, and 40% +/- 16, respectively. The rates for primary assisted patency were 78% +/- 12, 67% +/- 14, and 67% +/- 14 and those for secondary patency were 91% +/- 9, 81% +/- 12, and 54% +/- 23. At 12 months, primary unassisted patency with de novo stent-graft placement was 90% +/- 9, whereas that with stent-grafts placed during TIPS revision was 17% +/- 15 (P = .005). At 12 months, the primary unassisted patency in patients with stent-grafts confined to the parenchymal tract was 75% +/- 22, and that of patients with stent-grafts extending at least 1 cm into the portal vein was 40% +/- 17 (P = .21). CONCLUSION: In this small series, satisfactory long-term patency was observed among patients in whom Dacron-covered stent-grafts were placed during revision or de novo creation of TIPS. More favorable outcomes were observed when the stent-graft was placed during de novo TIPS creation and when the device was confined to the parenchymal tract.
Authors:
Charles T Lau; Mark Scott; S William Stavropoulos; Michael C Soulen; Jeffery A Solomon; Timothy W I Clark
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Publication Detail:
Type:  Journal Article     Date:  2005-07-06
Journal Detail:
Title:  Radiology     Volume:  236     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-07-25     Completed Date:  2005-09-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  725-9     Citation Subset:  AIM; IM    
Affiliation:
Section of Interventional Radiology, Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, 1 Silverstein, Philadelphia, PA, 19104, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Humans
Male
Middle Aged
Polyethylene Terephthalates*
Portasystemic Shunt, Transjugular Intrahepatic / instrumentation*
Prosthesis Design
Retrospective Studies
Stents*
Chemical
Reg. No./Substance:
0/Polyethylene Terephthalates

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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