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Patency and clinical outcomes of transjugular intrahepatic portosystemic shunt with polytetrafluoroethylene-covered stents versus bare stents: a meta-analysis.
MedLine Citation:
PMID:  21039832     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND AND AIM:  Transjugular intrahepatic portosystemic shunt (TIPS) with polytetrafluoroethylene-(PTFE)-covered stent has been increasingly used for patients with complications of portal hypertension. It is still debated whether the new endoprostheses will improve some clinical outcomes (except for shunt patency) compared to the bare stents. The aims of our meta-analysis were to explore the patency and clinical outcomes of TIPS with PTFE-covered stent-grafts versus bare stents.
METHODS: Pertinent studies were retrieved through PubMed (1950-2010), MEDLINE (1950-2010), and reference lists of key articles. Outcome measures were primary patency, risk of encephalopathy and survival. Time-to-event data analysis was used to calculate the overall hazard ratios (HR).
RESULTS: Six studies were identified including a total of 1275 patients (346 TIPS with PTFE-covered stent-grafts and 929 TIPS with bare stents). Pooled shunt patency data from four eligible studies suggested a significant improvement of primary patency in patients who were treated with PTFE-covered stent-grafts (HR = 0.28, 95% confidence interval [CI] 0.20-0.35). Pooled encephalopathy data from three eligible studies suggested a significant reduction of risk in the PTFE-covered group (HR = 0.65, 95%CI 0.45-0.86). Pooled survival data from four eligible studies also suggested a significant decrease of mortality in the PTFE-covered group (HR = 0.76, 95%CI 0.58-0.94). No statistical heterogeneity was observed between studies for either outcome.
CONCLUSIONS: This meta-analysis shows that the use of PTFE-covered stent-grafts clearly improves shunt patency without increasing the risk of hepatic encephalopathy and with a trend towards better survival.
Authors:
Zhiping Yang; Guohong Han; Qiong Wu; Xiaofei Ye; Zhichao Jin; Zhanxin Yin; Xingshun Qi; Ming Bai; Kaichun Wu; Daiming Fan
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  25     ISSN:  1440-1746     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  1718-25     Citation Subset:  IM    
Copyright Information:
© 2010 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
Affiliation:
Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
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Comment In:
J Gastroenterol Hepatol. 2010 Nov;25(11):1716-7   [PMID:  21039831 ]

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