Application of stent-grafts combined with long bare stents in transjugular intrahepatic portosystemic shunt

AIM: To assess the efficacy of stent-grafts combined with long bare stents in transjugular intrahepatic portosystemic shunt (TIPS).

METHODS: A total of 22 patients with gastroeso-phageal varices underwent TIPS therapies using stent-grafts combined with long bare stents from January 2012 to January 2015 at the Affiliated Nanhua Hospital of Nanhua University.

RESULTS: The technical success rate of TIPS was 100%. The portal vein pressure declined from 43.25 cmH₂O ± 4.56 cmH₂O (l cmH₂O = 0.098 kPa) to 23.78 cmH₂O ± 5.11 cmH₂O (t = 21.423, P < 0.01) after operation. Angiography showed that gastroesophageal varices disappeared in all patients. Both liver function and gastroesophageal varices markedly improved. During a follow-up period of 6-24 mo, the cumulative primary patency rates were 95.4% (21/22), 90.9% (20/22), and 86.3% (19/22) at 6, 12 and 24 mo after the procedure, respectively. No shunt occlusion occurred during the follow-up period.

CONCLUSION: TIPS using stent-grafts combined with long bare stents can markedly increase the shunt patency rate. Double stent technique is both safe and effective for the treatment of portal hypertension with exceptionally challenging anatomy.