Impact of PTFE-covered stent position and extension on TIPS patency.

Autor: Cho JK; Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street 1 Silverstein, Philadelphia, PA, 19104, USA. Joshua.cho@pennmedicine.upenn.edu., Serna J; Perelman School of Medicine - University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA., Clark TWI; Penn Presbyterian Medical Center, 51 N 39th St 4 Wright-Saunders, Philadelphia, PA, 19104, USA., Dagli M; Perelman School of Medicine - University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA., Mondschein JI; Perelman School of Medicine - University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA., Shlansky-Goldberg RD; Perelman School of Medicine - University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA., Trerotola SO; Perelman School of Medicine - University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA., Soulen MC; Perelman School of Medicine - University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA., Stavropoulos SW; Perelman School of Medicine - University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA., Nadolski GJ; Perelman School of Medicine - University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA.
Jazyk: angličtina
Zdroj: Abdominal radiology (New York) [Abdom Radiol (NY)] 2020 Nov; Vol. 45 (11), pp. 3915-3922.
DOI: 10.1007/s00261-020-02566-8
Abstrakt: Purpose: The objectives of this study were to determine the effects of expanded polytetrafluoroethylene (PTFE)-covered stent location and TIPS extension on primary patency.
Methods: This retrospective cohort study examined patients with PTFE-covered TIPS creation between 07/2002 and 06/2016. Clinical information and patency outcomes at 24 months were extracted. At TIPS creation, extension was performed at the discretion of the operator. Kaplan-Meier curves of primary patency were generated with conditional variables of HVO-HCJ distance, extension status, and covered versus uncovered extensions. Additional logistic regression analyses of distances were performed.
Results: Of 393 patients, 115 patients (29%) underwent stent extension, 79 (20% of total cohort) of which were at the HVO end alone. Primary patency for all TIPS was 75%, 68%, and 54% at 3, 6, and 12 months. The data endpoint were transplant or death in 92 (23%) and 116 (30%). Kaplan-Meier curves showed no statistically significant difference between the variables and primary patency at 12 and 24 months: distance up to versus greater than 10 mm (p = 0.32, 0.81); extension versus no extension (p = 0.83, 0.85); uncovered versus covered extensions (p = 0.58, 0.70). Logistic regression analyses showed a trend toward statistical significance.
Conclusion: In the setting of PTFE-covered TIPS creation, extended TIPSs and unextended well-positioned TIPSs have no difference in primary patency rates. Stent position and extension length may have an effect on primary patency, but were likely obscured by "user recognition" effects.
Databáze: MEDLINE
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