Repeat interventions for maintenance of transjugular intrahepatic portosystemic shunt function in patients with Budd-Chiari syndrome.
The authors report the role of transjugular intrahepatic portosystemic shunts (TIPS) and consecutive interventions, including brachytherapy (n = 2) and stent-graft placement (n = 3), to increase secondary patency and consequently postpone orthotopic liver transplantation (OLT) in the treatment of Budd-Chiari syndrome in eight patients. Two patients (with hematologic diseases) died 2 weeks after the TIPS procedure. Median follow-up in the six survivors was 42.5 months (range, 11-79 mo). Multiple TIPS occlusions occurred in three patients (range, 2-7 revisions). Reocclusions occurred despite brachytherapy and Hemobahn stent-graft placement and necessitated OLT in one patient. Revision-free patency was achieved in the other two patients after VIATORR stent-graft placement (16 and 32 months after TIPS creation). All patients with stable TIPS (n = 5) are without ascites, no liver failure occurred, and no patients are currently on the transplant list.
Cejna
Manfred
M
Department of Angiography and Interventional Radiology, Vienna Medical School, Vienna, Austria. manfred.cejna@univie.ac.at
Peck-Radosavljevic
Markus
M
Schoder
Maria
M
Thurnher
Siegfried
S
Ba-Ssalamah
Ahmed
A
Angermayr
Bernhard
B
Kaserer
Klaus
K
Pokrajac
Boris
B
Lammer
Johannes
J
D000328:Adult; D001918:Brachytherapy; D006502:Budd-Chiari Syndrome / Q000601:surgery* / Q000628:therapy; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D012008:Recurrence; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency