Shunt dysfunction patterns after transjugular intrahepatic portosystemic shunt creation using a combination of a generic stent-graft and bare-stents
Abstract Purpose Even though transjugular intrahepatic portosystemic shunt (TIPS) using Fluency Stent-grafts provides good shunt patency rates, shunt dysfunction is a great concern after TIPS creation, occurring in up to 20% of cases within one year. The objective of this study was to describe shunt...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2024-01-01
|
| Series: | CVIR Endovascular |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42155-023-00421-7 |
| _version_ | 1797355490569617408 |
|---|---|
| author | Guillaume Gravel Florent Artru Miriam Gonzalez-Quevedo Georgia Tsoumakidou Nicolas Villard Rafael Duran Alban Denys |
| author_facet | Guillaume Gravel Florent Artru Miriam Gonzalez-Quevedo Georgia Tsoumakidou Nicolas Villard Rafael Duran Alban Denys |
| author_sort | Guillaume Gravel |
| collection | DOAJ |
| description | Abstract Purpose Even though transjugular intrahepatic portosystemic shunt (TIPS) using Fluency Stent-grafts provides good shunt patency rates, shunt dysfunction is a great concern after TIPS creation, occurring in up to 20% of cases within one year. The objective of this study was to describe shunt dysfunction patterns after TIPS creation using a combination of generic stent-grafts/bare-stents. Materials and methods Single-center retrospective study of all TIPS revisions between January 2005 and December 2020. TIPS revision angiograms were analyzed for stents’ positions, stenoses’ diameters, and stenoses’ locations. Results Out of 99 TIPS, a total of 33 TIPS revisions were included. The median time to TIPS revision was 10.4 months. Angiograms showed four patterns of TIPS dysfunction-associated features (DAF), defined as follows: Type 1 was defined as stenosis located after the stent end in the hepatic vein (HV), type 2 as intra-stent stenosis located in the hepatic vein, type 3 as intra-stent stenosis or a kink in the parenchymal tract or the portal vein end of the TIPS, and type 4 as a complete TIPS occlusion. Types 1, 2, 3, and 4 were seen in 23 (69.7%), 5 (15.2%), 2 (6.1%), and 3 (9.1%) TIPS respectively. TIPS revision was successful in 30 (90.1%) patients with median pre- and post-TIPS revision PSG of 18.5 mmHg and 8 mmHg respectively (p < .001). Conclusion Our results illustrate the four angiographic patterns of TIPS DAF after TIPS creation using a combination of generic stent-grafts/bare-stents and emphasize the need for appropriate stent length extending to the HV/inferior vena cava junction. |
| first_indexed | 2024-03-08T14:11:55Z |
| format | Article |
| id | doaj.art-2b36c7285d454f27a36b242940ef3385 |
| institution | Directory Open Access Journal |
| issn | 2520-8934 |
| language | English |
| last_indexed | 2024-03-08T14:11:55Z |
| publishDate | 2024-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | CVIR Endovascular |
| spelling | doaj.art-2b36c7285d454f27a36b242940ef33852024-01-14T12:37:59ZengSpringerOpenCVIR Endovascular2520-89342024-01-01711710.1186/s42155-023-00421-7Shunt dysfunction patterns after transjugular intrahepatic portosystemic shunt creation using a combination of a generic stent-graft and bare-stentsGuillaume Gravel0Florent Artru1Miriam Gonzalez-Quevedo2Georgia Tsoumakidou3Nicolas Villard4Rafael Duran5Alban Denys6Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of LausanneDepartment of Liver Diseases, Rennes University HospitalDepartment of Gastroenterology and Hepatology, Lausanne University HospitalDepartment of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of LausanneDepartment of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of LausanneDepartment of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of LausanneDepartment of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of LausanneAbstract Purpose Even though transjugular intrahepatic portosystemic shunt (TIPS) using Fluency Stent-grafts provides good shunt patency rates, shunt dysfunction is a great concern after TIPS creation, occurring in up to 20% of cases within one year. The objective of this study was to describe shunt dysfunction patterns after TIPS creation using a combination of generic stent-grafts/bare-stents. Materials and methods Single-center retrospective study of all TIPS revisions between January 2005 and December 2020. TIPS revision angiograms were analyzed for stents’ positions, stenoses’ diameters, and stenoses’ locations. Results Out of 99 TIPS, a total of 33 TIPS revisions were included. The median time to TIPS revision was 10.4 months. Angiograms showed four patterns of TIPS dysfunction-associated features (DAF), defined as follows: Type 1 was defined as stenosis located after the stent end in the hepatic vein (HV), type 2 as intra-stent stenosis located in the hepatic vein, type 3 as intra-stent stenosis or a kink in the parenchymal tract or the portal vein end of the TIPS, and type 4 as a complete TIPS occlusion. Types 1, 2, 3, and 4 were seen in 23 (69.7%), 5 (15.2%), 2 (6.1%), and 3 (9.1%) TIPS respectively. TIPS revision was successful in 30 (90.1%) patients with median pre- and post-TIPS revision PSG of 18.5 mmHg and 8 mmHg respectively (p < .001). Conclusion Our results illustrate the four angiographic patterns of TIPS DAF after TIPS creation using a combination of generic stent-grafts/bare-stents and emphasize the need for appropriate stent length extending to the HV/inferior vena cava junction.https://doi.org/10.1186/s42155-023-00421-7Transjugular intrahepatic portosystemic shuntTIPS or Stent DysfunctionAngiographyStenosis |
| spellingShingle | Guillaume Gravel Florent Artru Miriam Gonzalez-Quevedo Georgia Tsoumakidou Nicolas Villard Rafael Duran Alban Denys Shunt dysfunction patterns after transjugular intrahepatic portosystemic shunt creation using a combination of a generic stent-graft and bare-stents CVIR Endovascular Transjugular intrahepatic portosystemic shunt TIPS or Stent Dysfunction Angiography Stenosis |
| title | Shunt dysfunction patterns after transjugular intrahepatic portosystemic shunt creation using a combination of a generic stent-graft and bare-stents |
| title_full | Shunt dysfunction patterns after transjugular intrahepatic portosystemic shunt creation using a combination of a generic stent-graft and bare-stents |
| title_fullStr | Shunt dysfunction patterns after transjugular intrahepatic portosystemic shunt creation using a combination of a generic stent-graft and bare-stents |
| title_full_unstemmed | Shunt dysfunction patterns after transjugular intrahepatic portosystemic shunt creation using a combination of a generic stent-graft and bare-stents |
| title_short | Shunt dysfunction patterns after transjugular intrahepatic portosystemic shunt creation using a combination of a generic stent-graft and bare-stents |
| title_sort | shunt dysfunction patterns after transjugular intrahepatic portosystemic shunt creation using a combination of a generic stent graft and bare stents |
| topic | Transjugular intrahepatic portosystemic shunt TIPS or Stent Dysfunction Angiography Stenosis |
| url | https://doi.org/10.1186/s42155-023-00421-7 |
| work_keys_str_mv | AT guillaumegravel shuntdysfunctionpatternsaftertransjugularintrahepaticportosystemicshuntcreationusingacombinationofagenericstentgraftandbarestents AT florentartru shuntdysfunctionpatternsaftertransjugularintrahepaticportosystemicshuntcreationusingacombinationofagenericstentgraftandbarestents AT miriamgonzalezquevedo shuntdysfunctionpatternsaftertransjugularintrahepaticportosystemicshuntcreationusingacombinationofagenericstentgraftandbarestents AT georgiatsoumakidou shuntdysfunctionpatternsaftertransjugularintrahepaticportosystemicshuntcreationusingacombinationofagenericstentgraftandbarestents AT nicolasvillard shuntdysfunctionpatternsaftertransjugularintrahepaticportosystemicshuntcreationusingacombinationofagenericstentgraftandbarestents AT rafaelduran shuntdysfunctionpatternsaftertransjugularintrahepaticportosystemicshuntcreationusingacombinationofagenericstentgraftandbarestents AT albandenys shuntdysfunctionpatternsaftertransjugularintrahepaticportosystemicshuntcreationusingacombinationofagenericstentgraftandbarestents |