Primary implantation of polyester-covered stent-grafts for transjugular intrahepatic portosystemic stent shunts (TIPSS): A pilot study

Cardiovasc Intervent Radiol. 1999 Jul-Aug;22(4):305-10. doi: 10.1007/s002709900393.

Abstract

Purpose: To investigate whether placement of a polyester-covered stent-graft increases the primary patency of transjugular intrahepatic portosystemic stent shunts (TIPSS).

Methods: Between 1995 and 1997 Cragg Endopro or Passager MIBS stent-grafts were used for the creation of TIPSS in eight male patients, 35-59 years of age (mean 48 years). All patients suffered from recurrent variceal bleeding and/or refractory ascites due to liver cirrhosis. Seven stent-grafts were dilated to a diameter of 10 mm, one to 12 mm. Follow-up was performed with duplex ultrasound, clinical assessment, and angiography.

Results: The technical success rate for creation of a TIPSS was 100%. The mean portosystemic pressure gradient decreased from 25 mmHg to 12 mmHg. In seven of eight patients TIPSS dysfunction occurred between 2 days and 3 years after stent-graft placement. In one patient the TIPSS is still primarily patent (224 days after creation). The secondary patency rates are 31 days to 3 years.

Conclusion: The primary use of polyester-covered stent-grafts for TIPSS did not increase primary patency rates in our small series.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adult
  • Biopsy
  • Blood Flow Velocity
  • Coated Materials, Biocompatible*
  • Esophageal and Gastric Varices / complications
  • Esophageal and Gastric Varices / diagnosis
  • Esophageal and Gastric Varices / physiopathology
  • Follow-Up Studies
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / surgery*
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / physiopathology
  • Male
  • Middle Aged
  • Phlebography
  • Pilot Projects
  • Polyesters*
  • Portal Vein / diagnostic imaging
  • Portal Vein / physiopathology
  • Portasystemic Shunt, Transjugular Intrahepatic / methods*
  • Postoperative Complications
  • Retrospective Studies
  • Stents*
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex

Substances

  • Coated Materials, Biocompatible
  • Polyesters