Document Detail

Is sonographic surveillance of polytetrafluoroethylene-covered transjugular intrahepatic portosystemic shunts (TIPS) necessary? A single centre experience comparing both types of stents.
MedLine Citation:
PMID:  18774362     Owner:  NLM     Status:  MEDLINE    
AIM: To investigate whether sonographic (US) surveillance of polytetrafluoroethylene covered transjugular intrahepatic portosystemic shunts (TIPS) is necessary. MATERIALS AND METHODS: We identified 128 patients who underwent TIPS for complications of portal hypertension between January 2001 and December 2005 at a large tertiary centre. Procedural data were retrospectively analysed. US surveillance of the TIPS was performed at baseline with scheduled follow-up or whenever shunt dysfunction was suspected. Clinical and radiology reports were compared to assess US surveillance of the TIPS. RESULTS: Four hundred and twenty-six US studies were performed, with a median of three per patient (range 1-5). The median follow-up period was 378 days (range 1-1749 days). Twenty-three patients (18%) had baseline US studies performed only whereas 105 (82%) also had follow-up studies. Forty-one (32%) of 128 patients [32 (78%) Wallstent, nine (22%) Viatorr] had Doppler ultrasound abnormalities noted. Venography was performed in all 41 patients. Abnormal venography and elevated hepatic venous pressure gradient (HVPG) was seen in 34 (82.9%) of the 41 patients [29 (85.3%) Wallstent, five (14.7%) Viatorr]. Among the 34 patients, 17 (50%) [13 (76.5%) Wallstent, four (23.5%) Viatorr] had venographic abnormalities noted at the hepatic venous end accompanied by increased HVPG. All four of the Viatorr patients had minor narrowing at the hepatic venous end and HVPG measurements that ranged 3-4 mm Hg above 12 mm Hg. CONCLUSION: Considering the improved patency of covered stents in TIPS, US surveillance may be superfluous after the baseline study.
J-J Pan; C Chen; B Geller; R Firpi; V I Machicao; J G Caridi; D R Nelson; G Morelli
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-07-16
Journal Detail:
Title:  Clinical radiology     Volume:  63     ISSN:  1365-229X     ISO Abbreviation:  Clin Radiol     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-08     Completed Date:  2008-11-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1306016     Medline TA:  Clin Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1142-8     Citation Subset:  IM    
Department of Medicine, Division of Gastroenterology, Section of Hepatobiliary Disease, University of Florida, Gainesville, FL 32610, USA.
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MeSH Terms
Coated Materials, Biocompatible
Follow-Up Studies
Hypertension, Portal / surgery*
Long-Term Care / methods
Middle Aged
Portasystemic Shunt, Transjugular Intrahepatic / instrumentation*,  methods
Postoperative Care / methods
Prosthesis Failure
Retrospective Studies
Ultrasonography, Doppler
Unnecessary Procedures
Vascular Patency
Reg. No./Substance:
0/Coated Materials, Biocompatible; 9002-84-0/Polytetrafluoroethylene

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

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