Evaluation of the Efficacy and Safety of Transjugular Intrahepatic Portosystemic Shunt Combined With Concurrent Antegrade Embolization of Large Spontaneous Portosystemic Shunts.

IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Ze Wang, Xiao-Yang Xu, Chen-You Liu, Jin-Tao Huang, Wan-Ci Li, Shuai Zhang, Jian Shen, Bin-Yan Zhong, Xiao-Li Zhu
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引用次数: 0

Abstract

Objectives: To compare the long-term efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) combined with concurrent antegrade embolization in treating portal hypertension with oesophagogastric variceal bleeding in patients with and without large spontaneous portosystemic shunts (L-SPSSs).

Materials and methods: We retrospectively analysed data from patients with portal hypertension who underwent TIPS from November 2015 to April 2022. The patients were screened according to the inclusion criteria and were divided into L-SPSSs group (L-S group) and Non L-SPSSs group (Non L-S group). The primary outcome was the 2-year liver transplantation-free survival (TFS) rate. Secondary outcomes contained the incidence of overt hepatic encephalopathy (OHE), ectopic embolization and the 2-year rebleeding rate.

Results: A total of 259 patients were enrolled (64 patients in L-S group and 195 patients in Non L-S group). The average age was 57.2 years, and the success rate of procedure was 100%. Baseline data showed no significant differences between two groups. There was a statistically significant difference in the 2-year liver transplantation-free rate between two groups (L-S vs. Non L-S, 84.38% vs. 71.28%; p = 0.045). OHE occurred in 19 (29.69%) patients with L-SPSSs and 104 (53.33%) patients without L-SPSSs, with a statistically significant difference (p = 0.001). And no statistically significant difference was found in ectopic embolism incidence rate and the 2-year rebleeding rate between two groups. Multivariate Cox regression analysis identified male gender, portal vein thrombosis and preoperative high blood ammonia levels as independent risk factors for long-term survival.

Conclusion: Compared to Non L-S group, the patients in L-S group achieve longer liver transplantation-free survival and lower incidence rate of OHE without increasing the risk of 2-year rebleeding and ectopic embolization.

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来源期刊
CiteScore
3.30
自引率
6.20%
发文量
133
审稿时长
6-12 weeks
期刊介绍: Journal of Medical Imaging and Radiation Oncology (formerly Australasian Radiology) is the official journal of The Royal Australian and New Zealand College of Radiologists, publishing articles of scientific excellence in radiology and radiation oncology. Manuscripts are judged on the basis of their contribution of original data and ideas or interpretation. All articles are peer reviewed.
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