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Percutaneous mechanical thrombectomy device assisted TIPS recanalization: a feasibility study.

Annette Thurner1, Anne Marie Augustin1, Oliver Götze2

  • 1Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany.

Acta Radiologica (Stockholm, Sweden : 1987)
|July 29, 2021
PubMed
Summary

Percutaneous mechanical thrombectomy safely restores blood flow in thrombosed transjugular intrahepatic portosystemic shunts (TIPS). This technique achieved 100% technical success and 80% clinical success in patients with acute or chronic TIPS occlusion.

Keywords:
Aspirex®SRotarex®STIPS revisionTransjugular intrahepatic portosystemic shuntacute TIPS occlusionchronic TIPS occlusionpercutaneous mechanical thrombectomy

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Area of Science:

  • Interventional Radiology
  • Hepatology
  • Vascular Surgery

Background:

  • Transjugular intrahepatic portosystemic shunt (TIPS) occlusion is a significant complication.
  • Effective debulking of the TIPS tract is crucial for restoring blood flow.

Purpose of the Study:

  • To assess the technical and clinical success of mechanical thrombectomy for thrombosed TIPS.
  • To evaluate the Aspirex®S and Rotarex®S systems in restoring TIPS patency.

Main Methods:

  • Mechanical thrombectomy-assisted revisions were performed in five patients with acute or chronic TIPS occlusions.
  • The procedure involved transjugular lesion crossing and device passages, with adjunctive therapies as needed.
  • Acute thrombosis was defined as occurring within 10 days; chronic thrombosis was indicated by symptoms for 6-8 weeks.

Main Results:

  • 100% technical success rate with no procedure-related complications.
  • 80% patient-based clinical success rate, with stable patency achieved in four patients for at least five months.
  • One patient experienced early re-thrombosis twice, highlighting a potential challenge in complex cases.

Conclusions:

  • Percutaneous mechanical thrombectomy is a technically feasible and safe method for TIPS recanalization.
  • The technique demonstrates a high clinical success rate for both acute and chronic TIPS occlusions.
  • This approach offers a promising solution for managing TIPS occlusion and improving portal hypertension symptoms.