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Transjugular intrahepatic portosystemic shunt in the treatment of portal hypertension using memotherm stents: a prospective multicenter study.
Cardiovasc Intervent Radiol. 2002 Nov-Dec; 25(6):506-12.CI

Abstract

PURPOSE

In a prospective multicenter study, efficacy and safety of transjugular intrahepatic portosystemic shunts (TIPS) were evaluated in the treatment of the complications of portal hypertension using a new self-expanding mesh-wire stent (Memotherm).

METHODS

One hundred and eighty-one patients suffering from variceal bleeding (either acute or recurrent) or refractory ascites were enrolled. Postinterventional follow-up lasted for 8.4 months on average. Differences were analyzed by the log-rank test (chi-square) or Wilcoxon test.

RESULTS

Shunt insertion was completed successfully in all patients (n = 181 patients, 100%). During follow-up, shunt occlusion was evident in 23 patients, and shunt stenosis was found in 33 patients (12.7% and 18.2%, respectively). Variceal rebleeding occurred in 20 of 139 patients (14.4%), with at least one episode of bleeding before TIPS treatment. The overall mortality rate of the patients treated by TIPS was 39.8%. In 51.4% of these cases (37 of 72 patients), however, the patients died within 30 days after TIPS placement. Analysis of subgroups showed that patients who underwent emergency TIPS for acute variceal bleeding had a significantly higher early mortality compared with other patient groups (p = 0.0014).

CONCLUSION

In the present prospective multicenter study, we were able to show that insertion of Memotherm stents is an effective tool for TIPS. The occlusion rates seem to be comparable to those reported for the Palmaz stent. It could be shown that in particular, those patients who were treated for acute bleeding were at high risk of early mortality. Consequently, in such a critical condition, the indication for TIPS has to be set carefully.

Authors+Show Affiliations

Department of Medicine B, University of Muenster, Muenster, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12183763

Citation

Domagk, Dirk, et al. "Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Portal Hypertension Using Memotherm Stents: a Prospective Multicenter Study." Cardiovascular and Interventional Radiology, vol. 25, no. 6, 2002, pp. 506-12.
Domagk D, Patch D, Dick R, et al. Transjugular intrahepatic portosystemic shunt in the treatment of portal hypertension using memotherm stents: a prospective multicenter study. Cardiovasc Intervent Radiol. 2002;25(6):506-12.
Domagk, D., Patch, D., Dick, R., Grosso, M., Rousseau, H., Otal, P., Goffette, P., Heinecke, A., Drees, M., Domschke, W., & Menzel, J. (2002). Transjugular intrahepatic portosystemic shunt in the treatment of portal hypertension using memotherm stents: a prospective multicenter study. Cardiovascular and Interventional Radiology, 25(6), 506-12.
Domagk D, et al. Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Portal Hypertension Using Memotherm Stents: a Prospective Multicenter Study. Cardiovasc Intervent Radiol. 2002 Nov-Dec;25(6):506-12. PubMed PMID: 12183763.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transjugular intrahepatic portosystemic shunt in the treatment of portal hypertension using memotherm stents: a prospective multicenter study. AU - Domagk,Dirk, AU - Patch,David, AU - Dick,Robert, AU - Grosso,Maurizio, AU - Rousseau,Hervé, AU - Otal,Philippe, AU - Goffette,Pierre, AU - Heinecke,Achim, AU - Drees,Markus, AU - Domschke,Wolfram, AU - Menzel,Josef, Y1 - 2002/08/19/ PY - 2002/8/17/pubmed PY - 2003/4/23/medline PY - 2002/8/17/entrez SP - 506 EP - 12 JF - Cardiovascular and interventional radiology JO - Cardiovasc Intervent Radiol VL - 25 IS - 6 N2 - PURPOSE: In a prospective multicenter study, efficacy and safety of transjugular intrahepatic portosystemic shunts (TIPS) were evaluated in the treatment of the complications of portal hypertension using a new self-expanding mesh-wire stent (Memotherm). METHODS: One hundred and eighty-one patients suffering from variceal bleeding (either acute or recurrent) or refractory ascites were enrolled. Postinterventional follow-up lasted for 8.4 months on average. Differences were analyzed by the log-rank test (chi-square) or Wilcoxon test. RESULTS: Shunt insertion was completed successfully in all patients (n = 181 patients, 100%). During follow-up, shunt occlusion was evident in 23 patients, and shunt stenosis was found in 33 patients (12.7% and 18.2%, respectively). Variceal rebleeding occurred in 20 of 139 patients (14.4%), with at least one episode of bleeding before TIPS treatment. The overall mortality rate of the patients treated by TIPS was 39.8%. In 51.4% of these cases (37 of 72 patients), however, the patients died within 30 days after TIPS placement. Analysis of subgroups showed that patients who underwent emergency TIPS for acute variceal bleeding had a significantly higher early mortality compared with other patient groups (p = 0.0014). CONCLUSION: In the present prospective multicenter study, we were able to show that insertion of Memotherm stents is an effective tool for TIPS. The occlusion rates seem to be comparable to those reported for the Palmaz stent. It could be shown that in particular, those patients who were treated for acute bleeding were at high risk of early mortality. Consequently, in such a critical condition, the indication for TIPS has to be set carefully. SN - 0174-1551 UR - https://www.unboundmedicine.com/medline/citation/12183763/Transjugular_intrahepatic_portosystemic_shunt_in_the_treatment_of_portal_hypertension_using_memotherm_stents:_a_prospective_multicenter_study_ L2 - https://dx.doi.org/10.1007/s00270-002-1837-9 DB - PRIME DP - Unbound Medicine ER -