TIPS Creation with Viatorr Stent-grafts for Variceal Hemorrhage: a Cohort Study in China

Abstract

Abstract Objectives To investigate the effectiveness and safety of transjugular intrahepatic portosystemic shunt (TIPS) insertion for the management of variceal hemorrhage in Chinese Viatorr era. Methods 114 consecutive TIPS patients with variceal hemorrhage were included. Viatorr endoprostheses were used in all patients. The cumulative rates of variceal rebleeding, overall survival, shunt dysfunctions and overt hepatic encephalopathy (HE) were calculated by GraphPad Prism 9.5 (GraphPad Software Inc., San Diego, CA, USA). Results The overall survival rates at 1, 2, 3, and 4 years were 90.4%, 83.3%, 75.6%, and 69.2%, respectively. Variceal rebleeding rates increased over time, with rates of 9.1% at 1 year, 14.1% at 2 years, 17.9% at 3 years, and 25% at 4 years. Shunt dysfunctions showed a cumulative rate of 4.6% at 1 year, 8.5% at 2 years, 13.3% at 3 years, and 20.4% at 4 years and the risk of overt HE showed a cumulative rates of 14.2%, 17.9%, 23%, and 24.6% at 1, 2, 3, and 4 years, respectively. Conclusion TIPS using Viatorr stents is a beneficial approach for recurrent variceal bleeding. Yet the long-term complications including OHE development, stent dysfunctions, and rebleeding remain a main concern of physicians. It is valuable to consider these complications and inform TIPS candidates prior to the procedures.