title: Influence of the secondary deployment of expanded polytetrafluoroethylene-covered stent grafts on maintenance of transjugular intrahepatic portosystemic shunt patency.
abstract: OBJECTIVE
  To evaluate the effects of secondary deployment of expanded polytetrafluoroethylene (ePTFE)-covered stent grafts in the treatment of dysfunctional transjugular intrahepatic portosystemic shunts (TIPSs) in comparison with other common approaches (conventional angioplasty or implantation of bare metal stents).
  
  
  METHODS
  A retrospective review of 121 dysfunctional bare metal TIPS presenting between 2000 and 2004 was conducted. The group was divided into four subgroups according to the type of intervention: conventional angioplasty (52 cases; 43%), bare metal stent deployment (35 cases; 28.9%), nondedicated ePTFE-covered stent-graft deployment (15 cases; 12.4%), and dedicated ePTFE-covered stent-graft deployment (19 cases; 15.7%). In all four groups, the primary patency after the specific intervention was calculated and mutually compared.
  
  
  RESULTS
  Primary patency rates after 12 and 24 months were 49.7% and 25.3%, respectively, in conventional angioplasty; 74.9% and 64.9%, respectively, with bare metal stents; 75.2% and 64.5%, respectively, with nondedicated ePTFE-covered stent grafts; and 88.1% and 80.8%, respectively, with dedicated ePTFE-covered stent grafts.
  
  
  CONCLUSIONS
  In the treatment of dysfunctional TIPS, better patency after the intervention was obtained by deploying dedicated ePTFE-covered stent grafts in comparison with conventional angioplasty, bare metal stents, and nondedicated ePTFE-covered stents.
authors.affiliation: Second Department of Internal Medicine, Teaching Hospital of Charles University, Sokolska, Hradec Králové, Czech Republic. vrtula@post.cz
authors.forename: Vaclav
authors.initials: V
authors.lastname: Jirkovsky
authors.forename: Tomas
authors.initials: T
authors.lastname: Fejfar
authors.forename: Vaclav
authors.initials: V
authors.lastname: Safka
authors.forename: Petr
authors.initials: P
authors.lastname: Hulek
authors.forename: Antonin
authors.initials: A
authors.lastname: Krajina
authors.forename: Vendelin
authors.initials: V
authors.lastname: Chovanec
authors.forename: Jan
authors.initials: J
authors.lastname: Raupach
authors.forename: Miroslav
authors.initials: M
authors.lastname: Lojik
authors.forename: Tomas
authors.initials: T
authors.lastname: Vanasek
authors.forename: Ondrej
authors.initials: O
authors.lastname: Renc
authors.forename: Shahzad M
authors.initials: SM
authors.lastname: Ali
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017130:Angioplasty / Q000295:instrumentation*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D016009:Chi-Square Distribution; D002648:Child; D020099:Coated Materials, Biocompatible; D018153:Czech Republic; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014654:Vascular Patency; D055815:Young Adult
chemical_list: D020099:Coated Materials, Biocompatible; D011138:Polytetrafluoroethylene