Abstract:

In interventional radiology department of clinical hospital № 27 (Moscow) since 2002 till 2009 TIPS was performed in 62 patients for hepatic cirrhosis with portal hypertension. One of the patients underwent orthotopic liver transplantation in Germany.
Material and methods. Mean age in the group was 5f ,6 y. o., 17 women, 45 men. Three types of stents were used: matrix stents, self-expanding and stent-grapfts. Patients were divided in 2 groups. In Group 1 (17 pts) we performed TIPS with stent-grafts (Gore Viatorr TIPS Endoprosthesis); in Group 2 (47 pts) bare metal stents were used (matrix stents Perico, Genesis, JoMed and self-expanding stents Za-stent, Zilver, Wallstent, sinus-SuperFlex Visual-Stent, SMART-control).
Results. During 18 months follow-up there were no thrombosis, significant stenosis in patients of Group 1, and primary patency rate was 100%. In Group 2 primary and secondary patency rates were 69,3% and 85,6% correspondingly. Freedom from recurr­ ent esophageal varices hemorrhage was 82,8% in Group 1 and 69,3% in Group 2, ascitis and hydrothorax regression - 93,9% and 80,0%, absence of hepatic cerebropathy progression - 93,9% and 80,0%, overall survival - 87,8% и 76,0% correspondingly.
Conclusions. Therefore use of stent-graft in TIPS procedure improve patency of intrahepatic shunt (p < 0,01), significantly reduce risk of recurrent variceal hemorrhage (0,1 < p < 0,5), and reduce volume of ascitis (0,1 < p < 0,5). It worth saying that cerebropathy progression was caused by non-compliance to diet, and was corrected with medicamental treatment. In long-term follow-up stent­ graft «Viatorr» deployment improves survival of patients (0,1 < p < 0,5). Introduction of stent-grafts marked a new stage of TIPS pro­ cedure improvement.

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