The presence of spontaneous portosystemic shunts increases the risk of ă complications after transjugular intrahepatic portosystemic shunt (TIPS) ă placement - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Diagnostic and Interventional Imaging Année : 2016

The presence of spontaneous portosystemic shunts increases the risk of ă complications after transjugular intrahepatic portosystemic shunt (TIPS) ă placement

Résumé

Purpose: The goal of this study was to identify clinical and imaging ă variables that are associated with an unfavorable outcome during the 30 ă days following transjugular intrahepatic portosystemic shunt (TIPS) ă placement. ă Material and methods: Fifty-four consecutive patients with liver ă cirrhosis (Child-Pugh 6-13, Model for End-stage Liver Disease 7-26) ă underwent TIPS placement for refractory ascites (n = 25), recurrent or ă uncontrolled variceal bleeding (n = 23) or both (n = 6). Clinical, ă biological and imaging variables including type of stent (covered n = ă 40; bare-stent n = 14), presence of spontaneous portosystemic shunt (n = ă 31), and variations in portosystemic pressure gradient were recorded. ă Early severe complication was defined as the occurrence of overt hepatic ă encephalopathy or death within the 30 days following TIPS placement. ă Results: Sixteen patients (30%) presented with early severe ă complication after TIPS placement. Child-Pugh score was independently ă associated with complication (HR = 1.52, P < 0.001). Among the imaging ă variables, opacification of spontaneous portosystemic shunt during TIPS ă placement but before its creation was associated with an increased risk ă of early complication (P = 0.04). The other imaging variables were not ă associated with occurrence of complication. ă Conclusion: Identification of spontaneous portosystemic shunt during ă TIPS placement reflects the presence of varices and is associated with ă an increased risk of early severe complication.

Dates et versions

hal-01482523 , version 1 (03-03-2017)

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Citer

Patrick Borentain, J. Soussan, Noémie Resseguier, D. Botta-Fridlund, Jean-Charles Dufour, et al.. The presence of spontaneous portosystemic shunts increases the risk of ă complications after transjugular intrahepatic portosystemic shunt (TIPS) ă placement. Diagnostic and Interventional Imaging, 2016, 97 (6), pp.643-650. ⟨10.1016/j.diii.2016.02.004⟩. ⟨hal-01482523⟩
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