Transjugular intrahepatic portosystemic shunt procedure

Efficacy of 10-mm versus 12-mm Wallstents

Jeanette Kuhn-Fulton, Scott O. Trerotola, Veronica J. Harris, John Snidow, Matthew S. Johnson, Mark A. Carey, Xiao Hua Zhou, Lawrence Lumeng

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

PURPOSE: To compare results of transjugular intrahepatic portosystemic shunt (TIPS) placement with 10- and 12-mm Wallstents. MATERIALS AND METHODS: Forty-six TIPS procedures in 47 patients were retrospectively reviewed. Wallstents that were 10 mm in diameter were used in 23 patients, and those that were 12 mm in diameter were used in 23 patients. Immediate results were compared, which included initial portosystemic gradient and Doppler measurements of blood flow velocity through the shunt at 1 day. Long-term patency and velocities were also assessed. RESULTS: TIPS were successfully created in 46 of 47 patients (98%). In one patient in the 10-mm group, the portal vein could not be accessed. When compared with TIPS in the 10-mm group, TIPS placed in the 12-mm group required dilation to larger diameters (mean, 11.1 vs 9.2 mm; P < .0001) to achieve an identical target gradient of 10 mm Hg and exhibited lower 1-day velocities (mean, 1.3 m/sec vs 1.7 m/sec; P < .03). The 1-day occlusion rate was 17% (four of 23 patients) in the 12-mm group versus 0% in the 10-mm group (P < .02). Patient survival was statistically significantly less in the 12-mm group (P < .03). CONCLUSION: Twelve-millimeter Wallstents yield statistically significantly poorer short- and long-term results in TIPS procedures. This is most likely due to the decreased radial strength of the larger stent, which is 50% less than that of the 10-mm stent.

Original languageEnglish (US)
Pages (from-to)658-664
Number of pages7
JournalRadiology
Volume199
Issue number3
DOIs
StatePublished - Jan 1 1996
Externally publishedYes

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Transjugular Intrahepatic Portasystemic Shunt
Stents
Blood Flow Velocity
Portal Vein
Dilatation
Survival

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Kuhn-Fulton, J., Trerotola, S. O., Harris, V. J., Snidow, J., Johnson, M. S., Carey, M. A., ... Lumeng, L. (1996). Transjugular intrahepatic portosystemic shunt procedure: Efficacy of 10-mm versus 12-mm Wallstents. Radiology, 199(3), 658-664. https://doi.org/10.1148/radiology.199.3.8637983

Transjugular intrahepatic portosystemic shunt procedure : Efficacy of 10-mm versus 12-mm Wallstents. / Kuhn-Fulton, Jeanette; Trerotola, Scott O.; Harris, Veronica J.; Snidow, John; Johnson, Matthew S.; Carey, Mark A.; Zhou, Xiao Hua; Lumeng, Lawrence.

In: Radiology, Vol. 199, No. 3, 01.01.1996, p. 658-664.

Research output: Contribution to journalArticle

Kuhn-Fulton, J, Trerotola, SO, Harris, VJ, Snidow, J, Johnson, MS, Carey, MA, Zhou, XH & Lumeng, L 1996, 'Transjugular intrahepatic portosystemic shunt procedure: Efficacy of 10-mm versus 12-mm Wallstents', Radiology, vol. 199, no. 3, pp. 658-664. https://doi.org/10.1148/radiology.199.3.8637983
Kuhn-Fulton, Jeanette ; Trerotola, Scott O. ; Harris, Veronica J. ; Snidow, John ; Johnson, Matthew S. ; Carey, Mark A. ; Zhou, Xiao Hua ; Lumeng, Lawrence. / Transjugular intrahepatic portosystemic shunt procedure : Efficacy of 10-mm versus 12-mm Wallstents. In: Radiology. 1996 ; Vol. 199, No. 3. pp. 658-664.
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abstract = "PURPOSE: To compare results of transjugular intrahepatic portosystemic shunt (TIPS) placement with 10- and 12-mm Wallstents. MATERIALS AND METHODS: Forty-six TIPS procedures in 47 patients were retrospectively reviewed. Wallstents that were 10 mm in diameter were used in 23 patients, and those that were 12 mm in diameter were used in 23 patients. Immediate results were compared, which included initial portosystemic gradient and Doppler measurements of blood flow velocity through the shunt at 1 day. Long-term patency and velocities were also assessed. RESULTS: TIPS were successfully created in 46 of 47 patients (98{\%}). In one patient in the 10-mm group, the portal vein could not be accessed. When compared with TIPS in the 10-mm group, TIPS placed in the 12-mm group required dilation to larger diameters (mean, 11.1 vs 9.2 mm; P < .0001) to achieve an identical target gradient of 10 mm Hg and exhibited lower 1-day velocities (mean, 1.3 m/sec vs 1.7 m/sec; P < .03). The 1-day occlusion rate was 17{\%} (four of 23 patients) in the 12-mm group versus 0{\%} in the 10-mm group (P < .02). Patient survival was statistically significantly less in the 12-mm group (P < .03). CONCLUSION: Twelve-millimeter Wallstents yield statistically significantly poorer short- and long-term results in TIPS procedures. This is most likely due to the decreased radial strength of the larger stent, which is 50{\%} less than that of the 10-mm stent.",
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AU - Trerotola, Scott O.

AU - Harris, Veronica J.

AU - Snidow, John

AU - Johnson, Matthew S.

AU - Carey, Mark A.

AU - Zhou, Xiao Hua

AU - Lumeng, Lawrence

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N2 - PURPOSE: To compare results of transjugular intrahepatic portosystemic shunt (TIPS) placement with 10- and 12-mm Wallstents. MATERIALS AND METHODS: Forty-six TIPS procedures in 47 patients were retrospectively reviewed. Wallstents that were 10 mm in diameter were used in 23 patients, and those that were 12 mm in diameter were used in 23 patients. Immediate results were compared, which included initial portosystemic gradient and Doppler measurements of blood flow velocity through the shunt at 1 day. Long-term patency and velocities were also assessed. RESULTS: TIPS were successfully created in 46 of 47 patients (98%). In one patient in the 10-mm group, the portal vein could not be accessed. When compared with TIPS in the 10-mm group, TIPS placed in the 12-mm group required dilation to larger diameters (mean, 11.1 vs 9.2 mm; P < .0001) to achieve an identical target gradient of 10 mm Hg and exhibited lower 1-day velocities (mean, 1.3 m/sec vs 1.7 m/sec; P < .03). The 1-day occlusion rate was 17% (four of 23 patients) in the 12-mm group versus 0% in the 10-mm group (P < .02). Patient survival was statistically significantly less in the 12-mm group (P < .03). CONCLUSION: Twelve-millimeter Wallstents yield statistically significantly poorer short- and long-term results in TIPS procedures. This is most likely due to the decreased radial strength of the larger stent, which is 50% less than that of the 10-mm stent.

AB - PURPOSE: To compare results of transjugular intrahepatic portosystemic shunt (TIPS) placement with 10- and 12-mm Wallstents. MATERIALS AND METHODS: Forty-six TIPS procedures in 47 patients were retrospectively reviewed. Wallstents that were 10 mm in diameter were used in 23 patients, and those that were 12 mm in diameter were used in 23 patients. Immediate results were compared, which included initial portosystemic gradient and Doppler measurements of blood flow velocity through the shunt at 1 day. Long-term patency and velocities were also assessed. RESULTS: TIPS were successfully created in 46 of 47 patients (98%). In one patient in the 10-mm group, the portal vein could not be accessed. When compared with TIPS in the 10-mm group, TIPS placed in the 12-mm group required dilation to larger diameters (mean, 11.1 vs 9.2 mm; P < .0001) to achieve an identical target gradient of 10 mm Hg and exhibited lower 1-day velocities (mean, 1.3 m/sec vs 1.7 m/sec; P < .03). The 1-day occlusion rate was 17% (four of 23 patients) in the 12-mm group versus 0% in the 10-mm group (P < .02). Patient survival was statistically significantly less in the 12-mm group (P < .03). CONCLUSION: Twelve-millimeter Wallstents yield statistically significantly poorer short- and long-term results in TIPS procedures. This is most likely due to the decreased radial strength of the larger stent, which is 50% less than that of the 10-mm stent.

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