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CC BY 4.0 · Journal of Clinical Interventional Radiology ISVIR
DOI: 10.1055/s-0045-1812488
Original Article

Retrospective Single-Center Study on Patency and Clinical Outcomes of Transjugular Intrahepatic Portosystemic Shunt Placement Using Niti-S Stents in Patients with Cirrhosis

Autoren

  • Rajesh Sasidharan 

    1   Division of Hepatobiliary Interventional Radiology, Rajagiri Hospital, Kochi, Kerala, India

  • Shubham Suryavanshi

    1   Division of Hepatobiliary Interventional Radiology, Rajagiri Hospital, Kochi, Kerala, India

  • Akhil Baby

    1   Division of Hepatobiliary Interventional Radiology, Rajagiri Hospital, Kochi, Kerala, India

  • Cyriac Abby Philips

    2   The Liver Unit, Rajagiri Hospital, Kochi, Kerala, India

  • Tharun Tom Oommen

    2   The Liver Unit, Rajagiri Hospital, Kochi, Kerala, India

  • Ajit Tharakan

    3   Center of Excellence in GI Sciences, Rajagiri Hospital, Kochi, Kerala, India
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Abstract

Purpose

To evaluate the primary patency rates and clinical outcomes of the Niti-S expanded polytetrafluoroethylene-covered stent when used for transjugular intrahepatic portosystemic shunt (TIPS) creation in cirrhotic patients, and to compare outcomes with published Viatorr benchmarks.

Methods

This retrospective single-center study included 96 cirrhotic patients who underwent de novo TIPS placement using Niti-S ComVi biliary (end bare-type) stents between April 2021 and March 2024. Indications included variceal bleeding (54%) and recurrent or refractory ascites (46%). TIPS creation followed a standardized protocol, and patients were prospectively followed with Doppler ultrasound and clinical assessment. The primary endpoint was 12-month primary patency, defined as uninterrupted stent function without re-intervention.

Results

Hemodynamic success was 100%, with significant reduction in portal pressure gradient (from 23  ±  5 to 9  ±  4 mmHg). Primary patency rates at 6 months, 1 year, and 2 years were 97, 96, and 92%, respectively. There was no significant difference in patency by TIPS indication. At 1 year, clinical outcomes demonstrated a 96% rate of freedom from rebleeding and complete resolution of ascites in 91% of patients. After a median follow-up of 20 months, 12.5% patients developed hepatic encephalopathy, including 3.2% with episodes of West Haven grade III–IV severity. Comparative analysis revealed that the patency rates and clinical outcomes of the Niti-S stent were on par with those reported for Viatorr.

Conclusion

The Niti-S covered stent demonstrated excellent 1-year patency and clinical efficacy in TIPS creation. It offers a viable alternative in resource-limited settings, with effective portal decompression and low complication rates.

Keywords

variceal bleeding - encephalopathy - ascites

Ethical Approval

This study was approved by our institutional ethics committee (RHIEC).


Informed Consent

Written informed consent was obtained from each patient (or their caregiver) prior to the treatment.




Publikationsverlauf

Artikel online veröffentlicht:
29. Oktober 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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