Role of transjugular intrahepatic portosystemic shunt in the control of variceal bleeding and ascites due to portal hypertension

Objective To investigate the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) created with PTFE- covered stents (FluencyRO) on variceal bleeding and ascites due to portal hypertension. Methods Clinical data of 55 patients with benign liver disease, who had undergone TIPS in our hospital from Feb. 2004 to Jan. 2010, were analyzed retrospectively. Long-term and short-term shunt patency was assessed; the survival time and the incidence of complications were analyzed. Results Technical success rate was 100% . Portal pressure gradients (PPG) of all the patients reached consensus standard (PPG ≤1.60 kPa, or PPG dropped by 2.00 kPa). The 1-, 2-, 3-, 4-, 5-year survival rates were 70.4%, 60.8%, 60.8%, 60.8% and 60.8%, the 1-, 2-, 3-, 4-, 5-year shunt dysfunction (restenosis) rates were 7.3%, 13.1%, 24.0%, 24.0% and 24.0%, the 1-, 2-, 3-, 4-, 5-year variceal rebleeding rates were 9.8% , 19.3% , 26.0% , 26.0% and 26.0% , and the 1 - , 2 - , 3 - , 4 - , 5 -year incidence rates of hepatic encephalopathy were 14.8%, 23.9%, 35.8%, 57.2% and 57.2%, respectively. Conclusions TIPS created with PTFE-covered stents is effective for the control of variceal bleeding and ascites due to portal hypertension with high patency rate. The incidence of complications such as hepatic encephalopathy and rebleeding is comparatively low.