Transjugular intrahepatic portosystemic shunts using the Wallstent prosthesis: a follow-up study.
OBJECTIVE
The aim of the present study was to assess the efficacy of transjugular intrahepatic portosystemic shunts (TIPS) in 45 patients with cirrhosis during a mean follow-up of 7 months.


METHODS
Forty-five consecutive patients treated by TIPS and who had been followed for at least 6 months after TIPS or until death, were included. Mean follow-up was 7.2 +/- 5.0 months. Shunt patency was assessed at 1 week and 1 month, then every 3 months after the procedure by Doppler US and angiography whenever needed.


RESULTS
Thirty-six patients had been stented for refractory bleeding from ruptured esophagogastric varices. Of these, 8 patients (22%) rebled, 7 of whom were treated by a second shunt. Nine patients were treated for refractory ascites. Three patients had recurrent ascites due to shunt obstruction. All were treated by a second shunt which occluded in 2 patients. As a whole, 14 (31.1%) patients developed shunt obstruction within a mean of 120 +/- 136 days, 4 of whom remained asymptomatic. Other complications were septicemia by Staphylococcus aureus in 1 patient, transient encephalopathy in 9 patients, and disseminated intravascular coagulation in 1 patient.


CONCLUSIONS
TIPS appears to be a relatively safe and effective technique in treating complications of portal hypertension in patients with cirrhosis. Shunt obstruction in 31% of our patients probably represents the most important limitation of this technique.
Rousseau
H
H
Service de Radiologie, CHU Rangueil, Toulouse, France.
Vinel
J P
JP
Bilbao
J I
JI
Longo
J M
JM
Maquin
P
P
Zozaya
J M
JM
Garcia-Villareal
L
L
Coustet
B
B
Railhac
N
N
Railhac
J J
JJ
D001201:Ascites / Q000209:etiology / Q000601:surgery; D004932:Esophageal and Gastric Varices / Q000209:etiology; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000601:surgery; D008103:Liver Cirrhosis / Q000150:complications; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical / Q000379:methods / Q000401:mortality; D015607:Stents; D015996:Survival Rate