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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/26375

Title: Expanded polytetrafluoroethylene-covered stent-grafts for transjugular intrahepatic portosystemic shunts in cirrhotic patients: Long-term patency and clinical outcome results
Authors: Geeroms, Barbara
Laleman, Wim
Laenen, Annouschka
Heye, Sam
Verslype, Chris
van der Merwe, Schalk
Nevens, Frederik
Maleux, Geert
Issue Date: 2017
Publisher: SPRINGER
Citation: EUROPEAN RADIOLOGY, 27(5), p. 1795-1803
Abstract: To retrospectively analyse long-term patency and overall survival of cirrhotic patients treated with TIPSS using e-PTFE-covered stents. Additionally, prognostic factors for better patency and survival were analysed. Two hundred and eighty-five consecutive cirrhotic patients with severe portal hypertension-related symptoms were included. Follow-up, including clinical assessment and duplex ultrasound, was analysed up to end of study, patient's death, liver transplantation or TIPSS-reduction. Patency rates and overall survival were estimated by the Kaplan-Meier method; potential differences in outcome between subgroups were calculated using the Pepe and Mori test. The 1-, 2- and 5-year primary patencies were 91.5 %, 89.2 % and 86.2 %, respectively, with no new shunt dysfunctions after 5 years' follow-up. TIPSS revision was performed more often in ascites patients (P = 0.02). The 1-, 4- and 10-year survival rates were 69.2 %, 52.1 % and 30.7 %, respectively. Survival was higher in Child-Pugh class A-B (P = 0.04), in the recurrent bleeding group (P = 0.008) and in patients with underlying alcoholic cirrhosis (P = 0.01). Long term, primary patency of e-PTFE-covered TIPSS stents remains very high (> 80 %); shunt revision was required more frequently in ascites patients. Overall survival was better in Child-Pugh A-B patients with recurrent variceal bleeding and alcoholic liver cirrhosis. aEuro cent Long-term primary patency rate of e-PTFE-covered TIPSS stents remains very high. aEuro cent No new shunt dysfunction was found after 5 years of follow-up. aEuro cent Shunt revision was required more frequently in ascites patients. aEuro cent Four and 10 years' overall survival was 50 and 30 %, respectively.
Notes: [Geeroms, Barbara; Heye, Sam; Maleux, Geert] Univ Hosp Leuven, Dept Radiol, Herestr 49, B-3000 Leuven, Belgium. [Geeroms, Barbara; Heye, Sam; Maleux, Geert] Katholieke Univ Leuven, Dept Imaging & Pathol, Leuven, Belgium. [Laleman, Wim; Verslype, Chris; van der Merwe, Schalk; Nevens, Frederik] Univ Hosp Leuven, Dept Hepatol, Leuven, Belgium. [Laenen, Annouschka] Katholieke Univ Leuven, Interuniv Inst Biostat & Stat Bioinformat, Leuven, Belgium. [Laenen, Annouschka] Univ Hasselt, Hasselt, Belgium.
URI: http://hdl.handle.net/1942/26375
DOI: 10.1007/s00330-016-4570-5
ISI #: 000399013900003
ISSN: 0938-7994
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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