Comparison of Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Cirrhosis With or Without Portal Vein Thrombosis: A Retrospective Study

作者：Hongliang Wang, Wei-Jie Lu, Yuelin Zhang, Chun‐Hui Nie, Tan‐Yang Zhou, Guan‐Hui Zhou, Tong‐Yin Zhu, Baoquan Wang, Sheng-Qun Chen, Zi‐Niu Yu, Jing Li, Junhui Sun · 发表于：Frontiers in Medicine · 年份：2021 · DOI：10.3389/fmed.2021.737984 · 被引用次数：9 · 研究领域：Liver Disease and Transplantation、Liver Disease Diagnosis and Treatment、Hepatitis Viruses Studies and Epidemiology

Aim: The purpose of our study was to conduct a retrospective analysis to compare the effectiveness of transjugular intrahepatic portosystemic shunts (TIPS) in the treatment of patients with cirrhosis with or without portal vein thrombosis (PVT). Methods: We included a total of 203 cirrhosis patients successfully treated with TIPS between January 2015 and January 2018, including 72 cirrhosis patients with PVT (35.5%) and 131 without PVT (64.5%). Our subjects were followed for at least 1 year after treatment with TIPS. Data were collected to estimate the mortality, shunt dysfunction, and complication rates after TIPS creation. Results: During the mean follow-up time of 19.5 ± 12.8 months, 21 (10.3%) patients died, 15 (7.4%) developed shunt dysfunction, and 44 (21.6%) experienced overt hepatic encephalopathy (OHE). No significant differences in mortality ( P = 0.134), shunt dysfunction ( P = 0.214), or OHE ( P = 0.632) were noted between the groups. Age, model for end-stage liver disease (MELD) score, and refractory ascites requiring TIPS were risk factors for mortality. A history of diabetes, percutaneous transhepatic variceal embolization (PTVE), 8-mm diameter stent, and platelet (PLT) increased the risk of shunt dysfunction. The prevalence of variceal bleeding and recurrent ascites was comparable between the two groups (16.7 vs. 16.7% P = 0.998 and 2.7 vs. 3.8% P = 0.678, respectively). Conclusions: Transjugular intrahepatic portosystemic shunts are feasible in the management...