Clinical application of Viatorr covered stent in transjugular intrahepatic portosystemic shunt

Abstract

Objective To discuss the early curative effect of Viatorr covered stent used in transjugular intrahepatic portosystemic shunt(TIPS)treating cirrhotic portal hypertension. Methods Nine cirrhotic patients with portal hypertension combined with variceal hemorrhage in Shandong Provincial Hospital Affiliated to Shandong University between October 2015 and October 2016 were included.All of them received TIPS treatment using Viatorr covered stent.They underwent gastroscopy and ultrasound re-examination at 1-3 months after operation and re-examined every half a year.All patients underwent color Doppler ultrasound and enhanced CT examination after operation.The clinical curative effect and complication condition were analyzed retrospectively. Results Nine patients were operated successfully in one time and the successful rate of the technique was 100%.Portal pressure before and after TIPS were(31.22±4.92)mmHg and(18.44±3.58)mmHg(1 mmHg=0.133 kPa, pairing t test, t=10, P<0.001), respectively.The pressure decreased by(40.57±8.86)% after shunt compared with before.All 9 cases were followed up and the follow-up visit length was 1-12 months(averagely 194 days). During the follow-up, 1 patient died at 148 d after operation due to abdominal infection; 1 patient got spontaneous peritonitis and infectious shock at 83 d after operation and got recovery with anti-infection treatment; 1 patient got ulcerative bleeding caused by aspirin at 23 d after operation and the tarry stool disappeared after stopping taking aspirin; for the other 6 cases with repeated varicosed vein bleeding, the gastroscope examination at 1-3 months after operation showed that varicosed veins were relieved or disappeared and they got no symptom including haematemesis, tarry stool till the end of the follow-up visits.All patients got smooth TIPS shunts till the end of follow-up visits(or before death)and they had no symptoms of hepatic encephalopathy. Conclusions Viatorr covered stent can maintain the long-term circulation of shunts, reduce the rebreeding rate and lower the postoperative coincidence rate of hepatic encephalopathy, so it is a safe and effective treatment method for intrahepatic portosystemic stent shunt of patients with portal hypertension. Key words: Transjugular intrahepatic portosystemic shunt; Viatorr covered stent; Portal hypertension; Liver cirrhosis