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Clinical Outcomes of Transjugular Intrahepatic Portosystemic Shunt (Tips) Creation Using Fluency Versus Viatorr Stent-Grafts: A Single-Centre Retrospective Study

  • Clinical Investigation
  • TIPS
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the effects of transjugular intrahepatic portosystemic shunt (TIPS) creation using Fluency versus Viatorr stent-grafts on the long-term clinical outcomes.

Materials and Methods

This was a single-center retrospective study from January 2010 to October 2021 in 213 patients receiving TIPS with Fluency (Fluency group, n = 154) versus Viatorr (Viatorr group, n = 59) stent-grafts. Inclusion criteria were: age > 18 years old and TIPS creation for variceal hemorrhage. Exclusion criteria were: age > 80 years old, concomitant chronic heart or lung disease, active tuberculosis or human immunodeficiency virus infection, extrahepatic malignancy, alcohol dependence, TIPS created outside of our hospital, without any follow-up data, or decline to participate. The primary outcome was primary patency rate and its associated risk factors.

Results

The 5-year cumulative primary patency rate was significantly higher in Viatorr group than in Fluency group (89.0% vs. 19.6%, p < 0.001), whereas the 5-year cumulative transplant-free survival rate (62.3% vs. 62.2%, p = 0.636) was comparable between two groups. Cox-regression models revealed that group (hazard ratio [HR]4.029, 95% confidence interval [CI] 1.486–10.927, p = 0.006), use of bare stents (HR 3.307, 95% CI 1.903–5.747, p < 0.001), and baseline portal vein thrombosis (HR 0.248, 95% CI 0.149–0.412, p < 0.001) were significantly associated with shunt patency. Incidences of adverse events were not significantly different between two groups (p > 0.05).

Conclusions

TIPS creation using Viatorr stent-grafts is superior to using Fluency stent-grafts in terms of higher long-term primary patency rate but similar transplant-free survival rate.

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Abbreviations

TIPS:

Transjugular intrahepatic portosystemic shunt

ePTFE:

Expanded polytetrafluoroethylene

HR:

Hazard ratio

CI:

Confidence interval

HE:

Hepatic encephalopathy

CT:

Computed tomography

PVT:

Portal vein thrombosis

PTA:

Percutaneous angioplasty

CTP:

Child–Turcotte–Pugh

MELD:

Model for end-stage liver disease

HBV:

Hepatitis B virus

PT:

Prothrombin time

INR:

International normalized ratio

AST:

Aspartate aminotransferase

WBC:

White blood cell counts

PPG:

Portal venous pressure gradient

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Author notes

  1. Hua-Mei Wu, Song-Quan Huang have Contributed equally to this study.

Authors and Affiliations

  1. Gastroenterology Department II, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, Yunnan, China

    Hua-Mei Wu, Yue-Meng Wan, Yu-Hua Li & Ying Xu

  2. Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, Yunnan, China

    Song-Quan Huang

Authors
  1. Hua-Mei Wu
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Contributions

Hua-Mei Wu, Song-Quan Huang: patient management and follow-up; acquisition of data; drafting manuscript. Yu-Hua Li: patient management and follow-up; acquisition of data. Yue-Meng Wan: study concept and design; statistical analysis and interpretation; draft revison; critical revision of the manuscript for important intellectual content. Ying Xu: study design; administrative, technical, or material support; study coordination and supervision.

Corresponding author

Correspondence to Yue-Meng Wan.

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Conflicts of interest

All authors including Hua-Mei Wu, Song-Quan Huang, Yue-Meng Wan, Yu-Hua Li, Ying Xu declared no conflict of interest.

Ethical Approval

This study was approved by our institutional ethics committee and conformed to the Helsinki Declaration of 1975, as revised in 2008.

Informed Consent

Individual written informed consents for the TIPS procedures were obtained from all patients or their authorized trustees.

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Wu, HM., Huang, SQ., Wan, YM. et al. Clinical Outcomes of Transjugular Intrahepatic Portosystemic Shunt (Tips) Creation Using Fluency Versus Viatorr Stent-Grafts: A Single-Centre Retrospective Study. Cardiovasc Intervent Radiol 45, 552–562 (2022). https://doi.org/10.1007/s00270-022-03102-5

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  • DOI: https://doi.org/10.1007/s00270-022-03102-5

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