Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Portal Hypertension Using Memotherm Stents: A Prospective Multicenter Study

Journal Article · Sun Dec 15 04:00:00 EST 2002 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-002-1837-9· OSTI ID:21083396

Domagk, Dirk ^[1]; Patch, David; Dick, Robert ^[2]; Grosso, Maurizio ^[3]; Rousseau, Herve; Otal, Philippe ^[4]; Goffette, Pierre ^[5]; Heinecke, Achim ^[6]; Drees, Markus; Domschke, Wolfram; Menzel, Josef ^[1]

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1. Department of Medicine B, University of Muenster, Muenster (Germany)
2. Department of Diagnostic Radiology, Royal Free Hospital, London (United Kingdom)
3. Department of Radiology, University ofTurin, Turin (Italy)
4. Department of Radiology, Centre Hospitalier Universitaire-Hopital de Rangueil, Toulouse (France)
5. Department ofRadiology, University Hospital Saint-Luc, Catholic University ofLouvain, Brussels (Belgium)
6. Department of Medical Statistics, University of Muenster, Muenster (Germany)

Purpose: In a prospective multicenter study, efficacy and safety of transjugular intrahepatic portosystemic shunts (TIPS) were evaluated in the treatment of the complications of portal hypertension using a new self-expanding mesh-wire stent(Memotherm). Methods: One hundred and eighty-one patients suffering from variceal bleeding (either acute or recurrent)or refractory ascites were enrolled. Post interventional follow-up lasted for 8.4 months on average. Differences were analyzed by the log-rank test (chi-square) or Wilcoxon test. Results:Shunt insertion was completed successfully in all patients(n = 181 patients, 100%). During follow-up, shunt occlusion was evident in 23 patients, and shunt stenosis was found in 33 patients (12.7% and 18.2%, respectively). Variceal rebleeding occurred in 20 of 139 patients (14.4%), with at least one episode of bleeding before TIPS treatment. The overall mortality rate of the patients treated by TIPS was 39.8%. In 51.4% of these cases (37 of 72 patients), however, the patients died within 30 days after TIPS replacement. Analysis of subgroups showed that patients who underwent emergency TIPS for acute variceal bleeding had a significantly higher early mortality compared with other patient groups (p= 0.0014). Conclusion: In the present prospective multicenter study, we were able to show that insertion of Memothermstents is an effective tool for TIPS. The occlusion rates seem to be comparable to those reported for the Palmaz stent. It could be shown that in particular, those patients who were treated for acute bleeding were at high risk of early mortality. Consequently, in such a critical condition, the indication for TIPS has to be set carefully.

• OSTI ID: 21083396
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 6 Vol. 25; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ASCITES
BYPASSES
HYPERTENSION
MORTALITY
PATIENTS