Primary implantation of polyester-covered stent-grafts for transjugular intrahepatic portosystemic stent shunts (TIPSS): A pilot study.
OBJECTIVE
To investigate whether placement of a polyester-covered stent-graft increases the primary patency of transjugular intrahepatic portosystemic stent shunts (TIPSS).


METHODS
Between 1995 and 1997 Cragg Endopro or Passager MIBS stent-grafts were used for the creation of TIPSS in eight male patients, 35-59 years of age (mean 48 years). All patients suffered from recurrent variceal bleeding and/or refractory ascites due to liver cirrhosis. Seven stent-grafts were dilated to a diameter of 10 mm, one to 12 mm. Follow-up was performed with duplex ultrasound, clinical assessment, and angiography.


RESULTS
The technical success rate for creation of a TIPSS was 100%. The mean portosystemic pressure gradient decreased from 25 mmHg to 12 mmHg. In seven of eight patients TIPSS dysfunction occurred between 2 days and 3 years after stent-graft placement. In one patient the TIPSS is still primarily patent (224 days after creation). The secondary patency rates are 31 days to 3 years.


CONCLUSIONS
The primary use of polyester-covered stent-grafts for TIPSS did not increase primary patency rates in our small series.
Department of Angiography and Interventional Radiology, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
M
M
Cejna
S
S
Thurnher
J
J
Pidlich
K
K
Kaserer
M
M
Schoder
J
J
Lammer
D000328:Adult; D001706:Biopsy; D001783:Blood Flow Velocity; D020099:Coated Materials, Biocompatible; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D010865:Pilot Projects; D011091:Polyesters; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex
D020099:Coated Materials, Biocompatible; D011091:Polyesters