TIPS: comparison of shunt patency and clinical outcomes between bare stents and expanded polytetrafluoroethylene stent-grafts.
OBJECTIVE
To compare shunt patency and clinical outcomes in two groups of patients who received a transjugular intrahepatic portosystemic shunt (TIPS): one group with bare stents and one with expanded polytetrafluoroethylene stent-grafts.


METHODS
TIPS were created with bare stents (n = 41) or stent-grafts (n = 40). Overall TIPS patency rates were compared between these two groups, as were clinical outcomes in patients with variceal bleeding and those with ascites.


RESULTS
In the bare stent group, primary shunt patency rates were 63%, 48%, and 24% at 3, 6, and 12 months, respectively. Secondary patency rates were 75% and 62% at 3 and 6 months, respectively. In the stent-graft group, primary patency rates were 94%, 67%, and 38% at 3, 6, and 12 months, respectively. Secondary patency rates were 100% and 92% at 3 and 6 months, respectively. All stent patency rates were higher in the stent-graft group, but only the difference in the 3-month primary patency rate (63% vs 94%) reached significance (P = .03). In patients with variceal bleeding as well as those with ascites, early and overall clinical success rates were higher in the stent-graft group, but only the 3-month and 12-month differences were statistically significant.


CONCLUSIONS
TIPS created with stent-grafts had better 3-month primary patency rates and better 3-month and 12-month clinical success rates compared with those created with bare stents.
Jung
Hyun S
HS
Department of Radiology, Massachusetts General Hospital and Harvard Medical School, GRB-290, 55 Fruit Street, Boston, MA 02114, USA.
Kalva
Sanjeeva Prasad
SP
Greenfield
Alan J
AJ
Waltman
Arthur C
AC
Walker
Thomas G
TG
Athanasoulis
Christos A
CA
Wicky
Stephan T
ST
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis; D019544:Equipment Failure Analysis; D005260:Female; D005465:Fluorocarbon Polymers; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000295:instrumentation* / Q000379:methods; D011474:Prosthesis Design; D011475:Prosthesis Failure; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency
D005465:Fluorocarbon Polymers; C010946:polytetrafluoroethane