title: Technical and clinical outcome of transjugular intrahepatic portosystemic stent shunt: bare metal stents (BMS) versus viatorr stent-grafts (VSG).
abstract: OBJECTIVE
  To compare retrospectively angiographical and clinical results in patients undergoing transjugular intrahepatic portosystemic stent-shunt (TIPS) using BMS or VSG.
  
  
  METHODS
  From February 2001 to January 2010, 245 patients underwent TIPS. From those, 174 patients matched the inclusion criteria with elective procedures and institutional follow-up. Group (I) consisted of 116 patients (mean age, 57.0±11.1 years) with BMS. Group (II) consisted of 58 patients with VSG (mean age, 53.5±16.1 years). Angiographic and clinical controls were scheduled at 3, 6 and 12 months, followed by clinical controls every 6 months. Primary study goals included hemodynamic success, shunt patency as well as time to and number of revisions. Secondary study goals included clinical success.
  
  
  RESULTS
  Hemodynamic success was 92.2% in I and 91.4% in II (n.s.). Primary patency was significantly higher in II compared to I (53.8% after 440.4±474.5 days versus 45.8% after 340.1±413.8 days; p<0.05). The first TIPS revision was performed significantly later in II compared to I (288.3±334.7 days versus 180.1±307.0 days; p<0.05). In the first angiographic control, a portosystemic pressure gradient ≥15 mmHg was present in 73.9% in I and in 39.4% in II (p<0.05). Clinical success was 73.7-86.2% after 466.3±670.1 days in I and 85.7-90.5% after 617.5±642.7 days in II (n.s.). Hepatic encephalopathy was 37.5% in I and 36.5% in II (n.s.).
  
  
  CONCLUSIONS
  VSG increased primary shunt patency as well as decreased time to and number of TIPS revisions. There was a trend of higher clinical success in VSG without increased hepatic encephalopathy.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 110, 69120 Heidelberg, Germany. cmsommer@gmx.com
authors.forename: Christof M
authors.initials: CM
authors.lastname: Sommer
authors.forename: Theresa L
authors.initials: TL
authors.lastname: Gockner
authors.forename: Ulrike
authors.initials: U
authors.lastname: Stampfl
authors.forename: Nadine
authors.initials: N
authors.lastname: Bellemann
authors.forename: Peter
authors.initials: P
authors.lastname: Sauer
authors.forename: Tom
authors.initials: T
authors.lastname: Ganten
authors.forename: Juergen
authors.initials: J
authors.lastname: Weitz
authors.forename: Hans U
authors.initials: HU
authors.lastname: Kauczor
authors.forename: Boris A
authors.initials: BA
authors.lastname: Radeleff
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008107:Liver Diseases / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000295:instrumentation*; D015995:Prevalence; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult