title: Uncovering the truth about covered stents: is there a difference between covered versus uncovered stents with transjugular intrahepatic portosystemic shunts?
abstract: BACKGROUND
  Polytetrafluoroethylene (PTFE)-covered transjugular intrahepatic portosystemic shunt (TIPS) stents purportedly provide superior patency. This study was undertaken to determine whether covered stents provide better long-term patency and outcomes after TIPSs.
  
  
  METHODS
  Patients with portal hypertension undergoing TIPS at a large teaching hospital from 2001 to 2010 were studied. Median data are presented.
  
  
  RESULTS
  Two hundred forty-six patients underwent TIPS; 70 received uncovered stents, and 176 received covered stents. Patients who received uncovered stents had more severely impaired liver function (41% were Child class C cirrhotics). The follow-up was longer with uncovered stents (48 vs 24 months, P < .01). Reinterventions for stenosis were undertaken in 33% with uncovered stents versus 19% with covered stents (P = .01). Shunt dysfunction occurred in 57% with uncovered stents versus 21% covered (P = .05). A deterioration of hepatic function occurred in 31% with uncovered stents versus 30% with covered (P = .32). Survival with uncovered stents was 31 months versus 33 months with covered stents (P = .55, Kaplan-Meier).
  
  
  CONCLUSIONS
  Covered stents may improve patency but do not mitigate postshunt hepatic dysfunction and do not improve survival.
authors.affiliation: Tampa General Medical Group, Tampa General Hospital, 409 Bayshore Boulevard, Tampa, FL 33606, USA.
authors.forename: Whalen
authors.initials: W
authors.lastname: Clark
authors.forename: Farhaad
authors.initials: F
authors.lastname: Golkar
authors.forename: Kenneth
authors.initials: K
authors.lastname: Luberice
authors.forename: Paul
authors.initials: P
authors.lastname: Toomey
authors.forename: Harold
authors.initials: H
authors.lastname: Paul
authors.forename: Andrea
authors.initials: A
authors.lastname: Marcadis
authors.forename: Chinyere
authors.initials: C
authors.lastname: Okpaleke
authors.forename: Michelle
authors.initials: M
authors.lastname: Vice
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hernandez
authors.forename: Angel
authors.initials: A
authors.lastname: Alsina
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Rosemurgy
mesh_terms: D020099:Coated Materials, Biocompatible; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D005260:Female; D006501:Hepatic Encephalopathy / Q000601:surgery; D006784:Hospitals, Teaching; D006801:Humans; D008103:Liver Cirrhosis / Q000145:classification / Q000401:mortality / Q000601:surgery; D017093:Liver Failure / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects / Q000295:instrumentation*; D011475:Prosthesis Failure; D012086:Reoperation; D012720:Severity of Illness Index; D015607:Stents / Q000009:adverse effects; D013927:Thrombosis / Q000209:etiology / Q000601:surgery
chemical_list: D020099:Coated Materials, Biocompatible; D011138:Polytetrafluoroethylene