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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.

KEYWORDS

Transjugular portosystemic shunt - stents - stent-grafts - complication - prognosis

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Manfred CejnaM.D. 

Department of Radiology, LKH Feldkirch, Carinagasse 47

A-6800 Feldkirch, Austria