Shunting branch of portal vein and stent position predict survival after transjugular intrahepatic portosystemic shunt.

Autor:	Bai M; Ming Bai, Chuang-Ye He, Xing-Shun Qi, Zhan-Xin Yin, Wen-Gang Guo, Jing Niu, Jie-Lai Xia, Zhuo-Li Zhang, Kai-Chun Wu, Dai-Ming Fan, Guo-Hong Han, Department of Liver Disease and Department of Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China., He CY; Ming Bai, Chuang-Ye He, Xing-Shun Qi, Zhan-Xin Yin, Wen-Gang Guo, Jing Niu, Jie-Lai Xia, Zhuo-Li Zhang, Kai-Chun Wu, Dai-Ming Fan, Guo-Hong Han, Department of Liver Disease and Department of Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China., Qi XS; Ming Bai, Chuang-Ye He, Xing-Shun Qi, Zhan-Xin Yin, Wen-Gang Guo, Jing Niu, Jie-Lai Xia, Zhuo-Li Zhang, Kai-Chun Wu, Dai-Ming Fan, Guo-Hong Han, Department of Liver Disease and Department of Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China., Yin ZX; Ming Bai, Chuang-Ye He, Xing-Shun Qi, Zhan-Xin Yin, Wen-Gang Guo, Jing Niu, Jie-Lai Xia, Zhuo-Li Zhang, Kai-Chun Wu, Dai-Ming Fan, Guo-Hong Han, Department of Liver Disease and Department of Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China., Wang JH; Ming Bai, Chuang-Ye He, Xing-Shun Qi, Zhan-Xin Yin, Wen-Gang Guo, Jing Niu, Jie-Lai Xia, Zhuo-Li Zhang, Kai-Chun Wu, Dai-Ming Fan, Guo-Hong Han, Department of Liver Disease and Department of Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China., Guo WG; Ming Bai, Chuang-Ye He, Xing-Shun Qi, Zhan-Xin Yin, Wen-Gang Guo, Jing Niu, Jie-Lai Xia, Zhuo-Li Zhang, Kai-Chun Wu, Dai-Ming Fan, Guo-Hong Han, Department of Liver Disease and Department of Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China., Niu J; Ming Bai, Chuang-Ye He, Xing-Shun Qi, Zhan-Xin Yin, Wen-Gang Guo, Jing Niu, Jie-Lai Xia, Zhuo-Li Zhang, Kai-Chun Wu, Dai-Ming Fan, Guo-Hong Han, Department of Liver Disease and Department of Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China., Xia JL; Ming Bai, Chuang-Ye He, Xing-Shun Qi, Zhan-Xin Yin, Wen-Gang Guo, Jing Niu, Jie-Lai Xia, Zhuo-Li Zhang, Kai-Chun Wu, Dai-Ming Fan, Guo-Hong Han, Department of Liver Disease and Department of Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China., Zhang ZL; Ming Bai, Chuang-Ye He, Xing-Shun Qi, Zhan-Xin Yin, Wen-Gang Guo, Jing Niu, Jie-Lai Xia, Zhuo-Li Zhang, Kai-Chun Wu, Dai-Ming Fan, Guo-Hong Han, Department of Liver Disease and Department of Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China., Larson AC; Ming Bai, Chuang-Ye He, Xing-Shun Qi, Zhan-Xin Yin, Wen-Gang Guo, Jing Niu, Jie-Lai Xia, Zhuo-Li Zhang, Kai-Chun Wu, Dai-Ming Fan, Guo-Hong Han, Department of Liver Disease and Department of Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China., Wu KC; Ming Bai, Chuang-Ye He, Xing-Shun Qi, Zhan-Xin Yin, Wen-Gang Guo, Jing Niu, Jie-Lai Xia, Zhuo-Li Zhang, Kai-Chun Wu, Dai-Ming Fan, Guo-Hong Han, Department of Liver Disease and Department of Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China., Fan DM; Ming Bai, Chuang-Ye He, Xing-Shun Qi, Zhan-Xin Yin, Wen-Gang Guo, Jing Niu, Jie-Lai Xia, Zhuo-Li Zhang, Kai-Chun Wu, Dai-Ming Fan, Guo-Hong Han, Department of Liver Disease and Department of Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China., Han GH; Ming Bai, Chuang-Ye He, Xing-Shun Qi, Zhan-Xin Yin, Wen-Gang Guo, Jing Niu, Jie-Lai Xia, Zhuo-Li Zhang, Kai-Chun Wu, Dai-Ming Fan, Guo-Hong Han, Department of Liver Disease and Department of Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China.
Jazyk:	angličtina
Zdroj:	World journal of gastroenterology [World J Gastroenterol] 2014 Jan 21; Vol. 20 (3), pp. 774-85.
DOI:	10.3748/wjg.v20.i3.774
Abstrakt:	Aim: To evaluate the effect of the shunting branch of the portal vein (PV) (left or right) and the initial stent position (optimal or suboptimal) of a transjugular intrahepatic portosystemic shunt (TIPS). Methods: We retrospectively reviewed 307 consecutive cirrhotic patients who underwent TIPS placement for variceal bleeding from March 2001 to July 2010 at our center. The left PV was used in 221 patients and the right PV in the remaining 86 patients. And, 224 and 83 patients have optimal stent position and sub-optimal stent positions, respectively. The patients were followed until October 2011 or their death. Hepatic encephalopathy, shunt dysfunction, and survival were evaluated as outcomes. The difference between the groups was compared by Kaplan-Meier analysis. A Cox regression model was employed to evaluate the predictors. Results: Among the patients who underwent TIPS to the left PV, the risk of hepatic encephalopathy (P = 0.002) and mortality were lower (P < 0.001) compared to those to the right PV. Patients who underwent TIPS with optimal initial stent position had a higher primary patency (P < 0.001) and better survival (P = 0.006) than those with suboptimal initial stent position. The shunting branch of the portal vein and the initial stent position were independent predictors of hepatic encephalopathy and shunt dysfunction after TIPS, respectively. And, both were independent predictors of survival. Conclusion: TIPS placed to the left portal vein with optimal stent position may reduce the risk of hepatic encephalopathy and improve the primary patency rates, thereby prolonging survival.
Databáze:	MEDLINE
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