Semin intervent Radiol 2005; 22(4): 287-299
DOI: 10.1055/s-2005-925555
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Should Stent-Grafts Replace Bare Stents for Primary Transjugular Intrahepatic Portosystemic Shunts?

Manfred Cejna1
  • 1Section of Interventional Radiology, Vienna Medical School, Austria; and Department of Radiology, LKH Feldkirch, Feldkirch, Austria
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Publication History

Publication Date:
03 January 2006 (online)

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ABSTRACT

Transjugular intrahepatic portosystemic shunt (TIPS) creation using bare stents is a second-line treatment for complications of portal hypertension due in part to the relatively high number of reinterventions and the occurrence of new or worsened encephalopathy. Initially, custom-made stent-grafts were used for TIPS revision in cases of biliary fistulae. Subsequently, custom stent-grafts were used for de novo TIPS creation. With the introduction of the VIATORR® TIPS endoprosthesis a dedicated stent-graft became available for TIPS creation and revision. The VIATORR® demonstrated its efficacy and superiority to uncovered stents in retrospective analyses, case-matched analyses, and randomized studies. The improved patency of stent-grafts has led many to requestion the role of TIPS as a second-line therapy. Currently, randomized trials are warranted to redefine the role of TIPS in the treatment of complications of portal hypertension.

REFERENCES

Manfred CejnaM.D. 

Department of Radiology, LKH Feldkirch, Carinagasse 47

A-6800 Feldkirch, Austria