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Transjugular intrahepatic portosystemic shunts using the Wallstent prosthesis: A follow-up study

  • Clinical Investigations
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Abstract

Purpose: The aim of the present study was to assess the efficacy of transjugular intrahepatic portosystemic shunts (TIPS) in 45 patients with cirrhosis during a mean follow-up of 7 months.

Methods: Forty-five consecutive patients treated by TIPS and who had been followed for at least 6 months after TIPS or until death, were included. Mean follow-up was 7.2±5.0 months. Shunt patency was assessed at 1 week and 1 month, then every 3 months after the procedure by Doppler US and angiography whenever needed.

Results: Thirty-six patients had been stented for refractory bleeding from ruptured esophagogastric varices. Of these, 8 patients (22%) rebled, 7 of whom were treated by a second shunt. Nine patients were treated for refractory ascites. Three patients had recurrent ascites due to shunt obstruction. All were treated by a second shunt which occluded in 2 patients. As a whole, 14 (31.1%) patients developed shunt obstruction within a mean of 120±136 days, 4 of whom remained asymptomatic. Other complications were septicemia byStaphylococcus aureus in 1 patient, transient encephalopathy in 9 patients, and disseminated intravascular coagulation in 1 patient.

Conclusion: TIPS appears to be a relatively safe and effective technique in treating complications of portal hypertension in patients with cirrhosis. Shunt obstruction in 31% of our patients probably represents the most important limitation of this technique.

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Authors and Affiliations

  1. Service de Radiologie, CHU Rangueil, Avenue J. Poulhes, F-31054, Toulouse, France

    Hervé Rousseau & Francis Joffre

  2. Service d'Hépato-Gastro-Entérologie et INSERM CJF 9107 CHU Purpan, Place du Dr., Baylac, F-31059, Toulouse, France

    Jean-Pierre Vinel M.D. & Jean-Pierre Pascal

  3. Department of Radiology, Clinica Universitaria de Navarra, Avenida Pio XII s/n, E-31008, Pamplona, Spain

    José I. Bilbao & Jésus M. Longo

  4. Service de Radiologie, CHU Purpan, Place du Dr. Baylac, F-31059, Toulouse, France

    Pierre Maquin & Jean-Jacques Railhac

  5. Department of Hepatology, Clinica Universitaria de Navarra, Avenida Pio XII s/n, E-31008, Pamplona, Spain

    José M. Zozaya, Luis Garcia-Villareal & Jésus Prieto

  6. Département d'Anesthésie Réanimation, CHU Purpan, Place du Dr. Baylac, F-31059, Toulouse, France

    Bernard Coustet & Nadine Railhac

  7. Department of Surgery, Clinica Universitaria de Navarra, Avenida Pio XII s/n, E-31008, Pamplona, Spain

    Javier Alvarez-Cienfuegos

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  1. Hervé Rousseau
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  2. Jean-Pierre Vinel M.D.
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  3. José I. Bilbao
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  4. JĂ©sus M. Longo
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  5. Pierre Maquin
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  7. Luis Garcia-Villareal
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  8. Bernard Coustet
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  9. Nadine Railhac
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  10. Jean-Jacques Railhac
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  11. Javier Alvarez-Cienfuegos
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  12. JĂ©sus Prieto
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  13. Francis Joffre
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  14. Jean-Pierre Pascal
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Rousseau, H., Vinel, JP., Bilbao, J.I. et al. Transjugular intrahepatic portosystemic shunts using the Wallstent prosthesis: A follow-up study. Cardiovasc Intervent Radiol 17, 7–11 (1994). https://doi.org/10.1007/BF01102064

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