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

Ming Bai, Chuang Ye He, Xing Shun Qi, Zhan Xin Yin, Jian Hong Wang, Wen Gang Guo, Jing Niu, Jie Lai Xia, Zhuo Li Zhang, Andrew C. Larson, Kai Chun Wu, Dai Ming Fan, Guo Hong Han*

*Corresponding author for this work

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)774-785
Number of pages12
JournalWorld Journal of Gastroenterology
Volume20
Issue number3
DOIs
StatePublished - Jan 28 2014

Keywords

  • Cirrhosis
  • Portal vein
  • Stent position
  • Transjugular intrahepatic portosystemic shunt
  • Variceal bleeding

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint Dive into the research topics of 'Shunting branch of portal vein and stent position predict survival after transjugular intrahepatic portosystemic shunt'. Together they form a unique fingerprint.

  • Cite this

    Bai, M., He, C. Y., Qi, X. S., Yin, Z. X., Wang, J. H., Guo, W. G., Niu, J., Xia, J. L., Zhang, Z. L., Larson, A. C., Wu, K. C., Fan, D. M., & Han, G. H. (2014). Shunting branch of portal vein and stent position predict survival after transjugular intrahepatic portosystemic shunt. World Journal of Gastroenterology, 20(3), 774-785. https://doi.org/10.3748/wjg.v20.i3.774