title: Follow-up study of transjugular intrahepatic portosystemic shunt in the treatment of portal hypertension.
abstract: OBJECTIVE
  To evaluate efficacy and complications for cirrhotic patients with variceal bleeding receiving TIPS.
  
  
  METHODS
  Of 137 patients who underwent TIPS from 2002 to 2009, 80 patients were included in this study. Information about the incidence of portosystemic encephalopathy (PSE) and rebleeding, and factors then which affected them, was collected by telephone call, letters, or follow-up visits in the out-patient department.
  
  
  RESULTS
  (1) TIPS can significantly reduce portal pressure and the risk of variceal bleeding. (2) A coated stent during TIPS can significantly reduce the occurrence of rebleeding in contrast with use of a  bare stent (13.51% vs. 32.56%, P < 0.05). (3) Incidence of PSE is related to the diameter of the stent; the wider the stent used, the greater the incidence of PSE. TIPS using the left branch of the portal vein can reduce the incidence of PSE. (4) TIPS combined with embolization has no effect on the incidence of rebleeding or PSE. (5) Mean survival was 77.098 months (95% CI, 68.568-85.628) and median survival 82.000 months (95% CI, 68.539-95.461) according to Kaplan-Meier survival analysis.
  
  
  CONCLUSIONS
  It is suggested that coated stents should be used to reduce rebleeding. It is recommended that 8 mm stents should be used for CHILD A and C patients and 8-10 mm stents for CHILD B patients during TIPS, and that TIPS should be considered as first-line therapy because it improves cumulative survival for cirrhotic patients with gastroesophageal variceal bleeding.
authors.affiliation: Department of Gastroenterology, First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, 710061 Xi'an, China. zj2@mail.xjtu.edu.cn
authors.forename: Hui
authors.initials: H
authors.lastname: Xue
authors.forename: Jia
authors.initials: J
authors.lastname: Yuan
authors.forename: Ying
authors.initials: Y
authors.lastname: Chao-Li
authors.forename: Muna
authors.initials: M
authors.lastname: Palikhe
authors.forename: Jia
authors.initials: J
authors.lastname: Wang
authors.forename: Liang
authors.initials: L
authors.lastname: Shan-Lv
authors.forename: Wen
authors.initials: W
authors.lastname: Qiao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006501:Hepatic Encephalopathy / Q000209:etiology; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult