eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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abstract:
Review paper

Transjugular intrahepatic portosystemic shunt: a meta-analysis of 8 mm versus 10 mm stents

Ping-Chao Huang
1
,
Meng Zhao
2
,
Yuan-Yuan Wei
1
,
Feng-Fei Xia
1
,
Hao Li
3

1.
Department of Interventional Vascular Surgery, Binzhou People’s Hospital, Binzhou, China
2.
Department of Radiology, Binzhou People’s Hospital, Binzhou, China
3.
Department of Interventional Radiology, Xuzhou Central Hospital, Xuzhou, China
Videosurgery Miniinv
Online publish date: 2021/03/08
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Introduction
Transjugular intrahepatic portosystemic shunt (TIPS) is an approach that is used to alleviate portal hypertension-related symptoms. The optimal stent diameter for TIPS remains controversial. Aim: To assess outcomes in patients who underwent TIPS using 8 mm and 10 mm stents.

Material and methods
The PubMed, Embase, and Cochrane Library databases were queried for all pertinent studies. The meta-analysis was conducted using RevMan v5.3. This meta-analysis was registered at the PROSPERO website (Number: CRD42020212392).

Results
Eighty-two potentially relevant articles were initially detected, with seven of these ultimately being included in this meta-analysis. Patients in the 10 mm stent group exhibited a significantly higher portosystemic pressure gradient (PPG) relative to the 8 mm group (p = 0.04), whereas no differences between groups were observed with respect to postoperative hepatic encephalopathy (HE, p = 0.25), re-bleeding (p = 0.82), liver transplantation (p = 0.45), or mortality (p = 0.43) rates. The TIPS dysfunction rate was significant lower in the 10 mm group (p = 0.01). In Asian studies, the postoperative HE rate was found to be significantly lower in the 8 mm group relative to the 10 mm group (p = 0.02), whereas all other endpoints were comparable between these groups. In Western studies, PPG values were significantly greater in the 10 mm group (p < 0.0001), whereas all other endpoint data were comparable between these groups.

Conclusions
TIPS with 10 mm stents provides a lower TIPS dysfunction rate. However, 8 mm stents may be recommended for Asian patients, as they can decrease the risk of postoperative HE.

keywords:

transjugular intrahepatic portosystemic shunt, 8 mm, 10 mm, meta-analysis

  
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