title: Expanded polytetrafluoroethylene-covered stent-grafts for transjugular intrahepatic portosystemic shunts in cirrhotic patients: Long-term patency and clinical outcome results.
abstract: OBJECTIVE
  To retrospectively analyse long-term patency and overall survival of cirrhotic patients treated with TIPSS using e-PTFE-covered stents. Additionally, prognostic factors for better patency and survival were analysed.
  
  
  METHODS
  Two hundred and eighty-five consecutive cirrhotic patients with severe portal hypertension-related symptoms were included. Follow-up, including clinical assessment and duplex ultrasound, was analysed up to end of study, patient's death, liver transplantation or TIPSS-reduction. Patency rates and overall survival were estimated by the Kaplan-Meier method; potential differences in outcome between subgroups were calculated using the Pepe and Mori test.
  
  
  RESULTS
  The 1-, 2- and 5-year primary patencies were 91.5 %, 89.2 % and 86.2 %, respectively, with no new shunt dysfunctions after 5 years' follow-up. TIPSS revision was performed more often in ascites patients (P = 0.02). The 1-, 4- and 10-year survival rates were 69.2 %, 52.1 % and 30.7 %, respectively. Survival was higher in Child-Pugh class A-B (P = 0.04), in the recurrent bleeding group (P = 0.008) and in patients with underlying alcoholic cirrhosis (P = 0.01).
  
  
  CONCLUSIONS
  Long term, primary patency of e-PTFE-covered TIPSS stents remains very high (>80 %); shunt revision was required more frequently in ascites patients. Overall survival was better in Child-Pugh A-B patients with recurrent variceal bleeding and alcoholic liver cirrhosis.
  
  
  CONCLUSIONS
  • Long-term primary patency rate of e-PTFE-covered TIPSS stents remains very high. • No new shunt dysfunction was found after 5 years of follow-up. • Shunt revision was required more frequently in ascites patients. • Four and 10 years' overall survival was 50 and 30 %, respectively.
authors.affiliation: Department of Radiology, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium.|Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.
authors.forename: Barbara
authors.initials: B
authors.lastname: Geeroms
authors.affiliation: Department of Hepatology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Laleman
authors.affiliation: Interuniversity Institute for Biostatistics and Statistical Bioinformatics, KU Leuven, Leuven, Belgium.|University of Hasselt, Hasselt, Belgium.
authors.forename: Annouschka
authors.initials: A
authors.lastname: Laenen
authors.affiliation: Department of Radiology, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium.|Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.
authors.forename: Sam
authors.initials: S
authors.lastname: Heye
authors.affiliation: Department of Hepatology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Chris
authors.initials: C
authors.lastname: Verslype
authors.affiliation: Department of Hepatology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Schalk
authors.initials: S
authors.lastname: van der Merwe
authors.affiliation: Department of Hepatology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Frederik
authors.initials: F
authors.lastname: Nevens
authors.affiliation: Department of Radiology, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium. geert.maleux@uzleuven.be.|Department of Imaging and Pathology, KU Leuven, Leuven, Belgium. geert.maleux@uzleuven.be.
authors.forename: Geert
authors.initials: G
authors.lastname: Maleux
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000453:epidemiology; D004932:Esophageal and Gastric Varices / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000209:etiology; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D055815:Young Adult
chemical_list: D011138:Polytetrafluoroethylene
keywords: Cirrhosis; Covered stent; Long-term outcome; Portal hypertension; Transjugular intrahepatic portosystemic shunt