Clinical study of transjugular intrahepatic portosystemic shunt with Viatorr stent in 43 cases
10.3760/cma.j.cn501113-20190225-00058
- VernacularTitle:43例采用Viatorr支架行经颈静脉肝内门体分流术的临床研究
- Author:
Hao ZHOU
1
;
Xin YAO
;
Shanhong TANG
;
Min XIE
;
Zhisong FENG
;
Jianping QIN
Author Information
1. 西部战区总医院消化内科，成都 610083
- Keywords:
Hypertension;
Portal;
Transjugular intrahepatic portosystemic shunt;
Viatorr stent
- From:
Chinese Journal of Hepatology
2021;29(1):54-59
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) with the use of Viator stent in the treatment of cirrhotic portal hypertension.Methods:43 cases with cirrhotic portal hypertension were implanted with Viatorr stent during TIPS procedure from March 2016 to August 2018. Serological indicators, color Doppler ultrasound, gastroscopy, rebleeding, ascites and hepatic encephalopathy were regularly followed up. Portal venous pressure, liver and kidney function, coagulation indexes were compared by t-test. Stent patency rate, hepatic encephalopathy incidence, rebleeding rate and survival rate were calculated by Kaplan-Meier curve.Results:TIPS procedure success rate was 100% in all patients. Portal pressure gradient was decreased from (25.57 ± 5.50) mmHg to (9.76 ± 2.92) mmHg before and after operation. Alanine aminotransferase (ALT) was significantly higher at 1 month after operation than before operation, but there was no significant difference between 3 and 6 months after and before operation. Total bilirubin, serum ammonia and prothrombin time at 1, 3, and 6 months after operation were higher than before operation. Albumin had no significant change compared with before operation, and creatinine and urea nitrogen were lower than before operation. The cumulative rebleeding rates at 12 and 24 months after operation was 0% and 9%, respectively. Of the 26 patients with ascites, 22 cases (84.6%) had complete disappearance of ascites and 3 (11.5%) had significant decrease of ascites. The cumulative incidence of hepatic encephalopathy at 3, 6, 12 and 24 months after surgery was 11.6%, 17.3%, 21.9% and 21.9%, respectively. The cumulative incidence of stent dysfunction at 12 and 24 months after surgery was 5.6% and 23.7%, respectively. The cumulative survival rate at 12 months and 24 months after surgery was 91.9%.Conclusion:TIPS procedure with Viatorr stent can effectively reduce portal pressure and rebleeding rate, improve intrahepatic shunt patency rate, and will not increase the risk of postoperative hepatic encephalopathy, and has a higher cumulative survival rate.
