Effectiveness of controlled-expansion transjugular intrahepatic portosystemic shunt (CX-TIPS) in an interdisciplinary setting at a large tertiary center

作者：M Hintersteininger, Julia Kappel, Theresa Müllner-Buscics, Susanne Riegler, Nina Dominik, Georg Kramer, Christian Sebesta, Paul Thöne, Albert Friedrich Stättermayer, Lukas Reider, Maria Schoder, Catharina Klausenitz, Raoul Varga, Fredrik Waneck, Michael Trauner, Mattias Mandorfer, Thomas Reiberger, Lukas Hartl · 发表于：Wiener klinische Wochenschrift · 年份：2025 · DOI：10.1007/s00508-025-02606-7 · 被引用次数：3 · 研究领域：Liver Disease and Transplantation、Organ Transplantation Techniques and Outcomes、Liver Disease Diagnosis and Treatment

INTRODUCTION: The use of controlled-expansion transjugular intrahepatic portosystemic shunt (CX-TIPS) effectively controls portal hypertension (PH)-related complications while reducing risks related to fully expanded stents. We evaluated the effectiveness of CX-TIPS in a large Viennese patient cohort. METHOD: We assessed the number of patients evaluated for CX-TIPS placement by interdisciplinary discussion at the Medical University of Vienna and included all patients from the prospective AUTIPS registry undergoing CX-TIPS placement between June 2018 - December 2024. After clinical and laboratory characterization at baseline, patients were followed up for clinical events. RESULTS: Overall, 200 patients underwent interdisciplinary evaluation for CX-TIPS. In 62.5% CX-TIPS was recommended and 82.4% of these patients underwent CX-TIPS placement. Among 103 patients with CX-TIPS placement between June 2018 - December 2024 (median age 57 years, 67.0% male, median MELD 11), the primary indication for CX-TIPS implantation was ascites (65.0%). The median portal pressure gradient decreased from 18 mm Hg to 8 mm Hg after CX-TIPS. Underdilated CX-TIPS placement was performed in 13.6% (n = 14) of patients and portal vein recanalization (PVR-TIPS) was performed in 4 patients. During a median follow-up time of 13.5 months, 30.1% of patients experienced hepatic encephalopathy and 5.8% cardiac decompensation. Kaplan-Meier survival analyses revealed 1‑year and 3‑year transplant-free survival rat...