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Cranial stent position is independently associated with the development of TIPS dysfunction
Complications of portal hypertension can be treated with transjugular intrahepatic portosystemic shunt (TIPS) in selected patients. TIPS dysfunction is a relevant clinical problem. This study investigated the prognostic value of two-dimensional (2D) TIPS geometry for the development of TIPS dysfunct...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8894460/ https://www.ncbi.nlm.nih.gov/pubmed/35241785 http://dx.doi.org/10.1038/s41598-022-07595-5 |
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author | Meyer, Carsten Paar Pérez, Alba Maria Chang, Johannes Sprinkart, Alois Martin Böhling, Nina Luu, Andreas Minh Kütting, Daniel Jansen, Christian Luetkens, Julian Bischoff, Leon Marcel Attenberger, Ulrike Strassburg, Christian P. Trebicka, Jonel Wolter, Karsten Praktiknjo, Michael |
author_facet | Meyer, Carsten Paar Pérez, Alba Maria Chang, Johannes Sprinkart, Alois Martin Böhling, Nina Luu, Andreas Minh Kütting, Daniel Jansen, Christian Luetkens, Julian Bischoff, Leon Marcel Attenberger, Ulrike Strassburg, Christian P. Trebicka, Jonel Wolter, Karsten Praktiknjo, Michael |
author_sort | Meyer, Carsten |
collection | PubMed |
description | Complications of portal hypertension can be treated with transjugular intrahepatic portosystemic shunt (TIPS) in selected patients. TIPS dysfunction is a relevant clinical problem. This study investigated the prognostic value of two-dimensional (2D) TIPS geometry for the development of TIPS dysfunction. Three hundred and seven patients undergoing TIPS procedure between 2014 and 2019 were analyzed in this monocentric retrospective study. 2D angiograms from the patients with and without TIPS dysfunction were reviewed to determine geometric characteristics including insertion and curve angles and the location of the stent. Primary outcome was the development of TIPS dysfunction. A total of 70 patients developed TIPS dysfunction and were compared to the dysfunction-free (n = 237) patients. The position of the cranial stent end in the hepatic vein and the persistence of spontaneous portosystemic shunts were significantly associated with the development of TIPS dysfunction. Among significant parameters in univariable regression analysis (portal vein-pressure after TIPS, Child–Pugh Score before TIPS, MELD before TIPS and white blood cell count before TIPS), multivariable models showed cranial stent position (p = 0.027, HR 2.300, 95% CI 1.101–4.806) and SPSS embolization (p = 0.006, HR 0.319, 95% CI 0.140–0.725) as the only predictors of TIPS dysfunction. This monocentric study demonstrates that the position of the cranial stent end is independently associated with the development of TIPS dysfunction. The distance of the cranial stent end to the IVC at the time of TIPS placement should be less than 1 cm in 2D angiography. |
format | Online Article Text |
id | pubmed-8894460 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-88944602022-03-07 Cranial stent position is independently associated with the development of TIPS dysfunction Meyer, Carsten Paar Pérez, Alba Maria Chang, Johannes Sprinkart, Alois Martin Böhling, Nina Luu, Andreas Minh Kütting, Daniel Jansen, Christian Luetkens, Julian Bischoff, Leon Marcel Attenberger, Ulrike Strassburg, Christian P. Trebicka, Jonel Wolter, Karsten Praktiknjo, Michael Sci Rep Article Complications of portal hypertension can be treated with transjugular intrahepatic portosystemic shunt (TIPS) in selected patients. TIPS dysfunction is a relevant clinical problem. This study investigated the prognostic value of two-dimensional (2D) TIPS geometry for the development of TIPS dysfunction. Three hundred and seven patients undergoing TIPS procedure between 2014 and 2019 were analyzed in this monocentric retrospective study. 2D angiograms from the patients with and without TIPS dysfunction were reviewed to determine geometric characteristics including insertion and curve angles and the location of the stent. Primary outcome was the development of TIPS dysfunction. A total of 70 patients developed TIPS dysfunction and were compared to the dysfunction-free (n = 237) patients. The position of the cranial stent end in the hepatic vein and the persistence of spontaneous portosystemic shunts were significantly associated with the development of TIPS dysfunction. Among significant parameters in univariable regression analysis (portal vein-pressure after TIPS, Child–Pugh Score before TIPS, MELD before TIPS and white blood cell count before TIPS), multivariable models showed cranial stent position (p = 0.027, HR 2.300, 95% CI 1.101–4.806) and SPSS embolization (p = 0.006, HR 0.319, 95% CI 0.140–0.725) as the only predictors of TIPS dysfunction. This monocentric study demonstrates that the position of the cranial stent end is independently associated with the development of TIPS dysfunction. The distance of the cranial stent end to the IVC at the time of TIPS placement should be less than 1 cm in 2D angiography. Nature Publishing Group UK 2022-03-03 /pmc/articles/PMC8894460/ /pubmed/35241785 http://dx.doi.org/10.1038/s41598-022-07595-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Meyer, Carsten Paar Pérez, Alba Maria Chang, Johannes Sprinkart, Alois Martin Böhling, Nina Luu, Andreas Minh Kütting, Daniel Jansen, Christian Luetkens, Julian Bischoff, Leon Marcel Attenberger, Ulrike Strassburg, Christian P. Trebicka, Jonel Wolter, Karsten Praktiknjo, Michael Cranial stent position is independently associated with the development of TIPS dysfunction |
title | Cranial stent position is independently associated with the development of TIPS dysfunction |
title_full | Cranial stent position is independently associated with the development of TIPS dysfunction |
title_fullStr | Cranial stent position is independently associated with the development of TIPS dysfunction |
title_full_unstemmed | Cranial stent position is independently associated with the development of TIPS dysfunction |
title_short | Cranial stent position is independently associated with the development of TIPS dysfunction |
title_sort | cranial stent position is independently associated with the development of tips dysfunction |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8894460/ https://www.ncbi.nlm.nih.gov/pubmed/35241785 http://dx.doi.org/10.1038/s41598-022-07595-5 |
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