Controlled underdilation using novel VIATORR® controlled expansion stents improves survival after transjugular intrahepatic portosystemic shunt implantation
| Autor: | Praktiknjo, Michael, Abu-Omar, Jasmin, Chang, Johannes, Thomas, Daniel, Jansen, Christian, Kupczyk, Patrick, Schepis, Filippo, Garcia-Pagan, Juan Carlos, Merli, Manuela, Meyer, Carsten, Strassburg, Christian P., Pieper, Claus C., Trebicka, Jonel |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
NEPTUN
Non-invasive Evaluation Program for TIPS and follow Up Network RA recurrent/refractory ascites VCX VIATORR controlled expansion Acute decompensation Ascites Cirrhosis Hepatic encephalopathy Liver TIPS Transjugular intrahepatic portosystemic shunt RC799-869 HF heart failure LVP large-volume paracentesis LV-GLS LV global longitudinal strain RAAS renin-angiotensin-aldosterone system VB variceal bleeding TIPS transjugular intrahepatic portosystemic shunt MELD model of end-stage liver disease LV left ventricular SPSS spontaneous portosystemic shunt PTFE polytetrafluorethylene Diseases of the digestive system. Gastroenterology HE hepatic encephalopathy CT computed tomography PSPG portosystemic pressure gradient VTS VIATORR TIPS stent TTE transthoracic echocardiography Research Article |
| Zdroj: | JHEP Reports, Vol 3, Iss 3, Pp 100264-(2021) JHEP Reports |
| Popis: | Background & Aims Smaller 8-mm diameter transjugular intrahepatic portosystemic shunts (TIPS) appear to be more beneficial than larger 10-mm TIPS stent-grafts, but lack the ability for secondary dilation in cases of clinical ineffectiveness. Underdilated VIATORR® TIPS stent grafts (VTS) expand passively, whereas novel VIATORR Controlled Expansion (VCX) stent grafts do not. This study evaluated the impact on survival of underdilated VCX compared with VTS in patients with decompensated cirrhosis. Methods This was a prospective case-control study including patients with cirrhosis receiving TIPS using 10-mm VCX underdilated to 8 mm. Patients with cirrhosis receiving 10-mm VTS underdilated to 8 mm were matched for age, sex, indication for TIPS, and liver function. Results A total of 114 patients (47 VCX, 47 VTS, and 20 fully dilated VCX/VTS) were included. After TIPS implantation, underdilated VCX diameter was 8.0 (7.8–9.2) mm at a median time of 359 (87–450) days, compared with VTS at 9.9 (9.7–10.0) mm (p Graphical abstract Highlights • Novel VIATORR® Controlled Expansion (VCX) stent grafts facilitate safe and stable underdilation to 8 mm of large 10-mm diameter stent-grafts. • Use of underdilated VCX improved outcome (survival, hepatic encephalopathy, ascites, and heart failure) compared with legacy VIATORR TIPS stent grafts (VTS). • Use of underdilated VCX preserved cardiac function compared with VTS. |
| Databáze: | OpenAIRE |
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