Influence of the Secondary Deployment of Expanded Polytetrafluoroethylene–covered Stent Grafts on Maintenance of Transjugular Intrahepatic Portosystemic Shunt Patency

• Published in: Journal of vascular and interventional radiology Vol. 22; no. 1; pp. 55 - 60
• Main Authors: Jirkovsky, Vaclav, MD, Fejfar, Tomas, MD, PhD, Safka, Vaclav, MD, PhD, Hulek, Petr, MD, PhD, Krajina, Antonin, MD, PhD, Chovanec, Vendelin, MD, PhD, Raupach, Jan, MD, PhD, Lojik, Miroslav, MD, Vanasek, Tomas, MD, PhD, Renc, Ondrej, MD, Ali, Shahzad M., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2011
• Subjects: Adolescent; Adult; Aged; Angioplasty - instrumentation; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - instrumentation; Chi-Square Distribution; Child; Coated Materials, Biocompatible; Czech Republic; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Polytetrafluoroethylene; Portasystemic Shunt, Transjugular Intrahepatic - adverse effects; Postoperative Complications - diagnostic imaging; Postoperative Complications - etiology; Postoperative Complications - physiopathology; Postoperative Complications - therapy; Prosthesis Design; Radiology; Retrospective Studies; Stents; Time Factors; Treatment Outcome; Ultrasonography, Doppler; Vascular Patency; Young Adult; expanded polytetrafluoroethylene; portosystemic gradient; ePTFE; PSG; transjugular intrahepatic portosystemic shunt; TIPS
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2010.09.016

Purpose To evaluate the effects of secondary deployment of expanded polytetrafluoroethylene (ePTFE)–covered stent grafts in the treatment of dysfunctional transjugular intrahepatic portosystemic shunts (TIPSs) in comparison with other common approaches (conventional angioplasty or implantation of bare metal stents). Materials and Methods A retrospective review of 121 dysfunctional bare metal TIPS presenting between 2000 and 2004 was conducted. The group was divided into four subgroups according to the type of intervention: conventional angioplasty (52 cases; 43%), bare metal stent deployment (35 cases; 28.9%), nondedicated ePTFE-covered stent-graft deployment (15 cases; 12.4%), and dedicated ePTFE-covered stent-graft deployment (19 cases; 15.7%). In all four groups, the primary patency after the specific intervention was calculated and mutually compared. Results Primary patency rates after 12 and 24 months were 49.7% and 25.3%, respectively, in conventional angioplasty; 74.9% and 64.9%, respectively, with bare metal stents; 75.2% and 64.5%, respectively, with nondedicated ePTFE-covered stent grafts; and 88.1% and 80.8%, respectively, with dedicated ePTFE-covered stent grafts. Conclusions In the treatment of dysfunctional TIPS, better patency after the intervention was obtained by deploying dedicated ePTFE-covered stent grafts in comparison with conventional angioplasty, bare metal stents, and nondedicated ePTFE-covered stents.