Effects of ePTFE-covered stents versus bare stents on portal hemodynamics in patients of transjugular intrahepatic portosystemic shunts / 中华普通外科杂志

ABSTRACT

Objective To study the effects of ePTFE-covered stents versus bare stents on portal hemodynamics in portal hypertensive patients receiving TIPS. Methods Sixty patients with portal hypertension underwent TIPS with 8 mm diameter bare stents and ePTFE-covered stent from April 2007 to April 2009. The clinical outcomes were observed after TIPS, and the hemodynamics of potal vein system were studied before and after TIPS and during the follow up using direct portography and color Doppler ultrasound technique. Results TIPS procedures were successful in all patients without major complications. The follow-up of patients with bare stents were (8 ± 4) months and follow-up of ePTFEcovered stents group were (6 ± 4) months. Immediately after the TIPS the portosystemic pressure gradient of the two groups decreased by 60% and 58%, respectively(t =0.79, P >0.05). During the follow-up,portosystemic pressure gradient of bare stents group increased gradually, while that in ePTFE-covered stents group maintained low portosystemic pressure gradient (13.2 ± 1.2) mm Hg vs. (9. 5 ± 2. 9) mm Hg, P =0. 015. The blood velocity and volume of venous return of potal vein system were significantly higher in ePTFE-covered stents group than in bare stents group during the follow-up using color Doppler ultrasound method. The blood velocity and volume of the shunts were significantly higher in covered stents group than in bare stents group after 1 year, (125 ±20) cm/s vs. (88 ±13) cm/s, and (1816 ±380) ml/min vs.(1074 ±239) ml/min, respectively P<0. 01. Conclusions In TIPS patients with ePTFE-covered stents high blood velocity and low portosystemic pressure gradient sustained in contrast with those using bare stents.