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Long-Term Follow-Up of TIPS Created with Expanded Poly-Tetrafluoroethylene Covered Stents.
MedLine Citation:
PMID:  23381105     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Transjugular intrahepatic portosystemic shunts (TIPS) created with expanded poly-tetrafluoroethylene-covered stents have largely replaced bare metal stents. Short-term shunt patency is typically assessed with protocol Doppler ultrasound (US), while little information exists with regard to long-term patency. AIM: We investigated the value of Doppler US in assessing TIPS patency as well as long-term clinical outcomes. METHODS: A retrospective analysis of 59 patients with covered stents used for TIPS between January 2001 and December 2011 was performed. RESULTS: Fifty-four patients had early (median 9 days) Doppler US follow-up. Seven of eight patients with an abnormal baseline US required stent revisions. None of the 46 patients with normal baseline Doppler US required revisions within the first 6 months; six of these patients subsequently had a portogram because of symptoms, but all TIPS were patent. Fifty-two patients survived for long-term (>6 months) follow-up, averaging 654 days and three Doppler US exams. Five of six patients with abnormal follow-up Doppler US required revisions, whereas none of the 46 patients with normal follow-up US had revisions. The recurrence of symptoms of portal hypertension and/or hepatic encephalopathy (HE) was low (4/52 patients). No significant predictors of long-term stenosis were identified. Post-TIPS HE was independent of pre-TIPS HE or Child-Pugh score. CONCLUSIONS: Short-term patency and that at approximately 2 years after TIPS placement was 87 and 77 %, respectively. We conclude that Doppler US at least 1 week after TIPS is warranted, but repeated Doppler US follow-up is probably not necessary in the absence of clinical symptoms.
Authors:
Krishna C Sajja; Bart L Dolmatch; Don C Rockey
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-5
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  -     ISSN:  1573-2568     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, 2140 Medical District Dr. #4022, Dallas, TX, 75235, USA, krishna.sajja@utsouthwestern.edu.
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