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Emergent TIPS for acute gastroesophageal variceal bleeding in cirrhotic patients with hepatocellular carcinoma

  • Interventional Radiology
  • Published:
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Abstract

Objectives

To estimate the safety and effectiveness of emergent transjugular intrahepatic portosystemic shunt (TIPS) creation for acute variceal bleeding (AVB) in cirrhotic patients with hepatocellular carcinoma (HCC).

Materials and methods

Data of thirty-three patients with AVB and HCC undergoing emergent TIPS creation from January 2016 to January 2022 were enrolled and were retrospectively analyzed. The primary outcomes were the safety of emergent TIPS creation, the bleeding control rate, and the rebleeding rate. The secondary outcomes included overall survival (OS), liver function, overt hepatic encephalopathy (HE), and shunt dysfunction.

Results

Emergent TIPS creation was technically successful in 33 patients (100%) and one (3.0%) patient suffered a major procedure-related adverse event. The control rate of bleeding (within 5 days) was 100%. During a median follow-up period of 26.3 months, rebleeding occurred in 6 (18.2%) patients. The median OS was 20.0 months. The 6-week and 1-year survival rates were 87% and 65%, respectively. Laboratory tests showed no significant impairment of liver function following TIPS creation. The incidences of overt HE and shunt dysfunction were 24.2% and 6.1%, respectively.

Conclusion

Emergent TIPS creation is feasible and effective for treatment of AVB in cirrhotic patients with HCC.

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Funding

This study was funded by Key R&D Program (Social Development) Project of Jiangsu Province (BE2021648) and the Suzhou People’s Livelihood Science and Technology Project (No. SS202059). Funding sources had no involvement in the financial support for the conduct of the research and preparation of the article.

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Author notes

  1. Jin-Tao Huang, Bin-Yan Zhong and Wan-Ci Li have contributed equally to this work.

Authors and Affiliations

  1. Department of Interventional Radiology, The First Affiliated Hospital, Soochow University, No. 188 Shizi Road, Suzhou, 215006, China

    Jin-Tao Huang, Bin-Yan Zhong, Wan-Ci Li, Nan Jiang, Duo Qian, Ze-Xin Hu, Hong Nie, Shuai Zhang, Jian Shen & Xiao-Li Zhu

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  1. Jin-Tao Huang
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The retrospective study was approved by the institutional review board at participating hospital. For this type of study formal consent is not required.

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Huang, JT., Zhong, BY., Li, WC. et al. Emergent TIPS for acute gastroesophageal variceal bleeding in cirrhotic patients with hepatocellular carcinoma. Abdom Radiol 49, 900–907 (2024). https://doi.org/10.1007/s00261-023-04088-5

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  • DOI: https://doi.org/10.1007/s00261-023-04088-5

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