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A New Choice for the Use of the Stents for Transjugular Intrahepatic Portosystemic Shunt Creation: Viabahn ePTFE covered stent/bare metal stent combination


 Background

Compare the clinical outcome of structure and function between insertion of transjugular intrahepatic portosystemic shunt (TIPS) created with the Viabahn ePTFE covered stent/bare metal stent (BMS) combination and Fluency ePTFE covered stent/BMS combination.
Methods

101 consecutive patients undergone TIPS procedure from February 2016 to August 2018 in our center were analyzed retrospectively, 64 subjects were enrolled in Viabahn group and 37 were Fluency group. We caculated the TIPS geometry characteristics and evaluated the related occurrence of shunt dysfunction, survival, overt hepatic encephalopathy (OHE) and variceal rebleeding.
Results

The technical success rate was 100%. After TIPS insertion, the rate of shunt dysfunction during the first 3 months was significantly different between Viabahn group and Fluency group, which were respectively 1.6% and 13.5% (p = 0.024). And multivariate analysis indicated that the angle of portalvenous inflow (α) (HR = 1.060, 95%CI = 1.009–1.112, p = 0.020) was the only predictor of shunt dysfunction. Besides, after 3 months following TIPS insertion, the α angle distinctly increased from 20.9°±14.3° to 26.9°±20.1° (p = 0.005) in Fluency group but stayed unchanged in Viabahn group (from 21.9°±15.1° to 22.9°±17.6°, p = 0.798).
Conclusions

The occurence of shunt dysfunction was related to the angle of portalvenous inflow (α), because of the slighter effect on α angle, after TIPS inplanation, Viabahn ePTFE covered stent/BMS combination was more stable in structure and promised higher short-term stent patency compared to Fluency ePTFE covered stent/BMS combination.