Investigation and analysis of the current status of transjugular intrahepatic portosystemic shunt treatment for portal hypertension in China
10.3760/cma.j.cn112149-20231113-00384
- VernacularTitle:中国门静脉高压症经颈静脉肝内门体分流术治疗现状的调查分析
- Author:
Haozhuo GUO
1
;
Meng NIU
;
Haibo SHAO
;
Xinwei HAN
;
Jianbo ZHAO
;
Junhui SUN
;
Zhuting FANG
;
Bin XIONG
;
Xiaoli ZHU
;
Weixin REN
;
Min YUAN
;
Shiping YU
;
Weifu LYU
;
Xueqiang ZHANG
;
Chunqing ZHANG
;
Lei LI
;
Xuefeng LUO
;
Yusheng SONG
;
Yilong MA
;
Tong DANG
;
Hua XIANG
;
Yun JIN
;
Hui XUE
;
Guiyun JIN
;
Xiao LI
;
Jiarui LI
;
Shi ZHOU
;
Changlu YU
;
Song HE
;
Lei YU
;
Hongmei ZU
;
Jun MA
;
Yanming LEI
;
Ke XU
;
Xiaolong QI
Author Information
1. 中国医科大学附属第一医院介入治疗科，沈阳 110001
- Keywords:
Hypertension, portal;
Transjugular intrahepatic portosystemic shunt;
Application status;
Questionnaire survey
- From:
Chinese Journal of Radiology
2024;58(4):437-443
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.
