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Related Experiment Videos

Stent graft in TIPS: technical and procedural aspects.

F Fanelli1, F M Salvatori, M Corona

  • 1Dipartimento di Scienze Radiologiche, Università di Roma La Sapienza, Viale Regina Elena 324, I-00161, Rome, Italy. fabrizio.fanelli@uniroma1.it

La Radiologia Medica
|June 23, 2006
PubMed
Summary

Transjugular intrahepatic portosystemic shunt (TIPS) using covered stent-grafts shows an 83.8% 1-year patency rate for portal hypertension. However, this procedure is associated with a high incidence of hepatic encephalopathy.

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Area of Science:

  • Interventional Radiology
  • Hepatology
  • Vascular Surgery

Background:

  • Transjugular intrahepatic portosystemic shunt (TIPS) is a key treatment for portal hypertension complications.
  • Intimal hyperplasia frequently causes shunt dysfunction and restenosis, leading to treatment failure.
  • Covered stent-grafts are being evaluated to improve TIPS primary patency.

Purpose of the Study:

  • To assess the efficacy and outcomes of using covered stent-grafts in TIPS procedures.
  • To evaluate the primary patency rates and complications associated with stent-graft use.
  • To determine the incidence of hepatic encephalopathy following TIPS with stent-grafts.

Main Methods:

  • Retrospective analysis of over 100 patients treated with Viatorr stent-graft for TIPS.

Related Experiment Videos

  • Follow-up ranging from 1 to 50 months to assess shunt patency.
  • Monitoring for complications, particularly shunt dysfunction and hepatic encephalopathy.

    • Main Results:

    • A 1-year primary patency rate of 83.8% was achieved with the Viatorr stent-graft.
    • Shunt dysfunction secondary to intimal hyperplasia was reduced.
    • A high rate of hepatic encephalopathy (46.6%) was observed, requiring intervention in refractory cases.

    Conclusions:

    • Covered stent-grafts, specifically the Viatorr, demonstrate good primary patency in TIPS procedures.
    • While effective in preventing restenosis, stent-graft use is linked to a significant risk of hepatic encephalopathy.
    • Management strategies for refractory hepatic encephalopathy, including TIPS reduction, are crucial.