Abstract
We conducted a single-center randomized trial to compare the efficacy of 8 mm Fluency covered stent and bare stent in transjugular intrahepatic portosystemic shunt (TIPS) for cirrhotic portal hypertension. From January 2006 to December 2010, the covered (experimental group) or bare stent (control group) was used in 131 and 127 patients, respectively. The recurrence rates of gastrointestinal bleeding (18.3% vs. 33.9%, P = 0.004) and refractory hydrothorax/ascites (6.9% vs. 16.5%, P = 0.019) in the experimental group were significantly lower than those in the control group. The cumulative restenosis rates in 1, 2, 3, 4, and 5-years in the experimental group (6.9%, 11.5%, 19.1%, 26.0%, and 35.9%, respectively) were significantly lower (P < 0.001) than those in the control group (27.6%, 37.0%, 49.6%, 59.8%, 74.8%, respectively). Importantly, the 4 and 5-year survival rates in the experimental group (83.2% and 76.3%, respectively) were significantly higher (P = 0.001 and 0.02) than those in the control group (71.7% and 62.2%, respectively). The rate of secondary interventional therapy in the experimental group was significantly lower than that in the control group (20.6% vs. 49.6%; P < 0.001). Therefore, Fluency covered stent has advantages over the bare stent in terms of reducing the restenosis, recurrence, and secondary interventional therapy, whereas improving the long-term survival for post-TIPS patients.
Highlights
The short-term efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in treating the complications caused by portal hypertension has been widely acknowledged[15,16,17,18,19,20,21,22,23]
Shunt channel restenosis could induce the recurrence of gastrointestinal bleeding or refractory ascites, and further affect the survival time
A multicenter prospective study on 114 patients receiving Viatorr covered stents found that restenosis rate at 6, 12, and 24 months was 8.1%, 20.1%, and 24.1%, respectively[12]
Summary
Department of Internal Medicine, College of Medicine, The University of Oklahoma Health Sciences Center, USA. *These authors contributed equally to this work. Correspondence and requests for materials should be addressed to www.nature.com/scientificreports/ Figure 1. Inclusion and exclusion criteria for patient recruitment in this retrospective study. compare the efficacies of 8 mm covered stent and 8 mm bare stent in 839 cases who underwent TIPS at Beijing Shijitan Hospital (as shown in Fig. 1). Among them, 258 patients with portal hypertension were treated with Fluency covered stent or bare stent.
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