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PTFE‐covered stents improve TIPS patency in Budd‐Chiari syndrome
Author(s) -
HernándezGuerra Manuel,
Turnes Juan,
Rubinstein Pablo,
Olliff Simon,
Elias Elwyn,
Bosch Jaime,
GarcíaPagán Juan Carlos
Publication year - 2004
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.20436
Subject(s) - medicine , stent , covered stent , transjugular intrahepatic portosystemic shunt , surgery , budd–chiari syndrome , polytetrafluoroethylene , incidence (geometry) , cirrhosis , portal hypertension , radiology , inferior vena cava , materials science , physics , optics , metallurgy
Transjugular intrahepatic portosystemic shunt (TIPS) have been shown to be an efficient portal‐systemic derivative treatment for Budd‐Chiari syndrome (BCS) patients uncontrolled by medical therapy. However, the main drawback of TIPS for this condition is a very high rate of shunt dysfunction. Recently, polytetrafluoroethylene (PTFE)‐covered stents have been shown to reduce the incidence of TIPS dysfunction in patients with cirrhosis. The aim of the study was to assess the incidence of TIPS dysfunction in 2 cohorts of BCS patients treated with bare or PTFE‐covered stents. The study included 25 TIPS procedures (16 bare stents and 9 covered stents) with a median follow‐up period of 20.4 months (range, 3.9‐124.8). Fourteen of 16 patients (87%) receiving bare stents had TIPS dysfunction compared to 3 of the 9 patients (33%) receiving PTFE‐covered stents ( P = .005). The actuarial rates of primary patency in the bare‐stent group were 19% at 1 year compared with 67% in the PTFE‐covered stent group ( P = .02; log‐rank test). The number of additional interventional procedures to maintain TIPS patency was significantly greater in the bare‐stent than in the PTFE‐covered stent group (1.9 ± 1.2 vs. 0.6 ± 0.9; P = .007). The number of patients with clinical relapses was greater in the bare‐stent group compared to the PTFE‐covered stent group (13 vs. 5 episodes in 9 and 3 patients, respectively). In conclusion , PTFE‐covered stents have a considerable advantage over bare stents for the TIPS treatment of BCS patients, with a lower dysfunction rate, a lower number of reinterventions, and fewer prosthesis requirements. PTFE‐covered stents are preferable in patients with Budd‐Chiari Syndrome. (H EPATOLOGY 2004;40:1197–1202.)

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