Clinical analysis of long-term outcomes of re-intervention of transjugular intrahepatic porto-systemic shunt
10.3760/cma.j.issn.1005.1201.2012.09.013
- VernacularTitle:经颈静脉肝内门-体分流术后再次介入治疗肝硬化门静脉高压长期疗效及再次手术原因分析
- Author:
Fuquan LIU
;
Zhendong YUE
;
Hongwei ZHAO
;
Lei WANG
;
Zhiwei LI
;
Lingxiang YU
;
Hanwei LI
;
Bo JIN
;
Zhenhua FAN
;
Mengfei ZHAO
;
Jiannan YAO
;
Li ZUO
- Publication Type:Journal Article
- Keywords:
Liver cirrhosis;
Hypertension,portal;
Portosystemic shunt, transjugular intrahepatic;
Radiography,interventional
- From:
Chinese Journal of Radiology
2012;46(9):830-835
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety,effectiveness and clinical factors of re-intervention of transjugular intrahepatic porto-systemic shunt (TIPS).Methods A retrospective study of safety and longterm outcomes of TIPS was made in 771 patients from August 1994 to August 2010.The 625 patients had follow-up data.The patients who received TIPS once,twice,and more than twice were divided into group 1,group 2 and group 3,respectively.Clinical symptoms,survival rate and restenosis rate of each group were analyzed.Clinical influencing factors of re-intervention effect were discussed.Results The success rate of first intervention was 98.2％ (757/771),the death rate was 0.7％ (5/757) and severe complication rate was 2.5％ (19/757).The success rate of re-intervention was 98.7％ (457/463),no death and severe complications occurred.The restenosis rate in group 3 decreased significantly than group 1 ( x2 =7.908,P ＜0.05 ) in the first year of TIPS.The restenosis rates in group 2 and group 3 were lower than group 1 from 2 to 5 years of TIPS ( x2 values were 27.046,25.724,37.002 and 19.046,respectively,P ＜ 0.05 ). The survival rate in group 3 was higher than group 1 (x2 =9.114,P＜0.05)and group 2 was higher than group 1 ( x2 =4.929,P ＜ 0.05 ) in the first year of TIPS,while there was no statistical difference between group 2 and group 3 ( x2 =2.678,P ＞ 0.05).The patients in group 2 and group 3 also had higher survival rates than group 1 from 2 to 5 years of TIPS (x2 value were 41.314,26.920,13.692 and 6.713,respectively,P ＜ 0.05 ).19.4％ (79/406)of patients who received re-intervention had symptom recurrence and shunt stenosis or occlusion. 11.6％ (47/406) of patients had symptom recurrence with portal hypertension signs,62.8％ (255/406) had shunt stenosis or occlusion with portal hypertension signs.Conclusions Restenosis or occlusion of TIPS,symptom recurrence and portal hypertension signs were important factors for re-intervention.Re-intervention of TIPS was safe and effective,and could improve the survival rate of patients with TIPS.
