title: Comparison of Technical and Clinical Outcome of Transjugular Portosystemic Shunt Placement Between a Bare Metal Stent and a PTFE-Stentgraft Device.
abstract: OBJECTIVE
  To analyse technical and clinical success of transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal hypertension and compare a stent and a stentgraft with regard to clinical and technical outcome and associated costs.
  
  
  METHODS
  170 patients (56 ± 12 years, 32.9% females) treated with TIPS due to portal hypertension were reviewed. 80 patients received a stent (group 1) and 83 a stentgraft (group 2), and seven interventions were unsuccessful. Technical data, periprocedural imaging, follow-up ultrasound and clinical data were analysed with focus on technical success, patency, clinical outcome and group differences. Cost analysis was performed.
  
  
  RESULTS
  Portal hypertension was mainly caused by ethyltoxic liver cirrhosis with ascites as dominant symptom (80%). Technical success was 93.5% with mean portosystemic gradient decrease from 16.1 ± 4.8 to 5.1 ± 2.1 mmHg. No significant differences in technical success and portosystemic gradient decrease between the groups were observed. Kaplan-Meier analysis yielded significant differences in primary patency after 14 days, 6 months and 2 years in favour of the stentgraft. Both groups showed good clinical results without significant difference in 1-year survival and hepatic encephalopathy rate. Costs to establish TIPS and to manage 2-year follow-up with constant patency and clinical success were 8876 € (group 1) and 9394 € (group 2).
  
  
  CONCLUSIONS
  TIPS is a safe and effective procedure to manage portal hypertension. Stent and stentgraft enabled good technical and clinical results with a low complication rate. Primary patency rates are clearly in favour of the stentgraft, whereas the stent was more cost effective with similar clinical results in both groups.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. jostlauermann@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Lauermann
authors.affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Potthoff
authors.affiliation: Department of Diagnostic and Interventional Radiology, Beaumont Hospital, Dublin, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Mc Cavert
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Marquardt
authors.affiliation: Institute of Biometry, Hannover Medical School, Hannover, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Vaske
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Rosenthal
authors.affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
authors.forename: T
authors.initials: T
authors.lastname: von Hahn
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Wacker
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: B C
authors.initials: BC
authors.lastname: Meyer
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. rodt.thomas@mh-hannover.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Rodt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000295:instrumentation*; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene
keywords: Ascites/peritoneal cavity fluid; Liver/hepatic; Portal vein hypertension; Transjugular intrahepatic portosystemic shunt (TIPS/TIPSS); Varices; Venous intervention