Long-term outcome following transjugular intrahepatic portosystemic shunt for variceal bleeding due to portal hypertension / 介入放射学杂志

ABSTRACT

Objective To study the 6 year outcome following transjugular intrahepatic portosystemic shunt (TIPSS) for variceal bleeding due to portal hypertension. Methods 65 patients, 51 males, 14 females, aged 35～72 years old with averaged 4.5 years, have been undergone TIPSS because of portal hypertension due to cirrhosis or Budd Chiari syndrome. The portal pressures were measured before and after TIPSS. Follow up study was done by color Doppler sonography or Barium esophageal radiogaphy for 3 months to 6 years (averaged 18 months). Repeated interventional treatments were done in cases of restenosis of the shunts. Results There were 0,2,10,5,0 cases of recurrent bleeding after 3 months, 6 months, 1 year, 2 year and 3—6 year following TIPSS respectively. Stenosis occurred in shunt paths due to thrombosis or smooth muscle cell proliferation or neointimal hyperplasia were relieved after thrombolytic therapy and repeated balloon angioplasty or stent plant among most of them. 2 were failed due to serious stenosis. 7 cases died, 2 of massive bleeding, 1 of the other cause and 4 of hepatic cancer. The other patients are getting well. Conclusions Although there were very high rates of restenosis (34%), but most of them could be treated again with interventional therapy, and in kept patency effectively. TIPSS is a still practical valuable management for massive gastric bleeding.