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European Radiology

, Volume 29, Issue 2, pp 699–706 | Cite as

Comparison of transjugular intrahepatic portosystemic shunt (TIPS) alone and combined with embolisation for the management of cardiofundal varices: a retrospective study

  • Jiaze Yu
  • Xiaoze Wang
  • Mingshan Jiang
  • Huaiyuan Ma
  • Zilin Zhou
  • Li Yang
  • Xiao LiEmail author
Vascular-Interventional
  • 183 Downloads

Abstract

Objectives

To assess the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) with and without adjunctive embolisation in managing cardiofundal varices bleeding.

Methods

The retrospective study comprised 82 patients (54 men; mean age 53.9 years; mean Model of End-stage Liver Disease score 9.3) with cardiofundal varices bleeding who underwent TIPS creation from 2011 to 2015. Variceal rebleeding, the outflow tracts of varices, overt hepatic encephalopathy (HE) and post-procedure varices patency were assessed.

Results

Gastrorenal shunt was present in 92.7% of patients (n = 76). Embolisation was performed in 67.1% of patients (n = 55). The 1- and 2-year variceal rebleeding rates in the TIPS combined with embolisation group were significantly lower than those in the TIPS alone group (3.8% and 13.4% vs 13.0% and 28.0%, respectively; p = 0.041). No significant differences between the two groups were found in the cardiofundal varices patency, overt HE or survival (p > 0.05).

Conclusions

The results suggest that TIPS combined with embolisation can reduce the risk of variceal rebleeding for patients with cardiofundal varices.

Key Points

TIPS combined with embolisation reduces the risk of rebleeding in treating cardiofundal varices.

TIPS combined with embolisation could not completely occlude cardiofundal varices.

TIPS combined with embolisation could not prevent the development of hepatic encephalopathy.

Keywords

TIPSS Gastric varix Embolotherapy Portal hypertension Bleeding 

Abbreviations and acronyms

BRTO

Balloon-occluded retrograde transvenous obliteration

CECT

Contrast-enhanced computed tomography

GOV

Gastro-oesophageal varices

GVs

Gastric varices

HE

Hepatic encephalopathy

IGV

Isolated gastric varices

LGV

Left gastric vein

PGV

Posterior gastric vein

PSG

Portosystemic pressure gradient

SGV

Short gastric vein

TIPS

Transjugular intrahepatic portosystemic shunt

Notes

Funding

This study has received funding by the Beijing Hope Run Special Fund of Cancer Foundation of China (Grant No. LC2015A01 to X.L.).

Compliance with Ethical Standards

Guarantor

The scientific guarantor of this publication is Xiao Li.

Conflict of Interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and Biometry

No complex statistical methods were necessary for this paper.

Informed Consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical Approval

Institutional review board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Institute of Interventional Radiology, West China HospitalSichuan UniversityChengduChina
  2. 2.Medical Imaging Department, First Affiliated Hospital of Kunming Medical UniversityKunming Medical UniversityKunmingChina
  3. 3.Department of Gastroenterology, West China HospitalSichuan UniversityChengduChina
  4. 4.Department of Radiology, West China HospitalSichuan UniversityChengduChina
  5. 5.Department of Interventional Therapy, National Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

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