دورية أكاديمية
Transjugular intrahepatic portosystemic shunts: long-term patency and clinical results in a patient cohort observed for 3-9 years.
| العنوان: | Transjugular intrahepatic portosystemic shunts: long-term patency and clinical results in a patient cohort observed for 3-9 years. |
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| المؤلفون: | ter Borg PC; Department of Gastroenterology and Hepatology, Erasmus MC, Dr. Molewaterplein 40, Room Ca 326, 3015 GD Rotterdam, The Netherlands. pterborg@zonnet.nl, Hollemans M, Van Buuren HR, Vleggaar FP, Groeneweg M, Hop WC, Laméris JS |
| المصدر: | Radiology [Radiology] 2004 May; Vol. 231 (2), pp. 537-45. Date of Electronic Publication: 2004 Mar 24. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Radiological Society of North America Country of Publication: United States NLM ID: 0401260 Publication Model: Print-Electronic Cited Medium: Print ISSN: 0033-8419 (Print) Linking ISSN: 00338419 NLM ISO Abbreviation: Radiology Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Easton, PA : Radiological Society of North America Original Publication: [Illinois?] : Radiological Society of North America, [1923]- |
| مواضيع طبية MeSH: | Portasystemic Shunt, Transjugular Intrahepatic*/mortality, Adult ; Aged ; Cohort Studies ; Female ; Hemorrhage/epidemiology ; Hepatic Encephalopathy/epidemiology ; Humans ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Recurrence ; Retrospective Studies ; Survival Rate ; Time Factors ; Vascular Patency |
| مستخلص: | Purpose: To retrospectively assess the outcome of transjugular intrahepatic portosystemic shunt (TIPS) placement in a nonselected group of consecutive patients. Materials and Methods: TIPS placement was attempted in 82 patients. Patients were followed up for at least 3 years according to a standard protocol that included repeated shunt evaluations. Fifty-four patients underwent TIPS placement for variceal bleeding, 24 for refractory ascites, and four for other indications. Recurrent bleeding, effect on ascites, long-term patency, development of encephalopathy, and survival and complication rates were evaluated with Kaplan-Meier survival analysis and Cox multivariate analysis. Results: TIPS placement was successful in 75 patients (91%). Mean follow-up lasted 29.4 months. Primary patency was 22% and 12%, primary-assisted patency was 67% and 46%, and secondary patency was 91% and 91% at 1- and 5-year follow-up, respectively. Nonalcoholic liver disease (P =.007) and increasing platelet counts (P =.006) independently predicted development of shunt insufficiency. The 1- and 5-year rates of recurrent variceal bleeding were 21% and 27%, respectively. In the majority of patients with refractory ascites, a beneficial effect of TIPS placement was observed. The risk for encephalopathy was 25% at 1-month follow-up and 52% at 3-year follow-up. The risk for chronic or severe intermittent encephalopathy was 15% at 1-year follow-up and 20% at 3-year follow-up. Serum creatinine levels (P =.001) and age (P =.02) were independent risk factors. Overall survival rate was 61%, 49%, and 42% at 1-, 3-, and 5-year follow-up, respectively. Age (P =.03), serum albumin level (P =.02), and serum creatinine level (P <.001) were independently related to mortality. Conclusion: The risk for definitive loss of shunt function was 17% at 5-year follow-up, indicating that surveillance with shunt revision-when indicated-results in excellent long-term TIPS patency. TIPS placement effectively protects against recurrent bleeding. |
| تواريخ الأحداث: | Date Created: 20040327 Date Completed: 20040629 Latest Revision: 20220330 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1148/radiol.2312021797 |
| PMID: | 15044746 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 0033-8419 |
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| DOI: | 10.1148/radiol.2312021797 |