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经颈静脉肝内门体分流术中扩张不足支架管腔内径的短期和长期演变

Short- and long-term evolution of the endoluminal diameter of underdilated stents in transjugular intrahepatic portosystemic shunt.

作者信息

Borghol S, Perarnau J M, Pucheux J, D'Alteroche L, Ayoub J, Trillaud H

机构信息

Department of Radiology, Hôpital Saint-André, 1, rue Jean-Burguet, 33000 Bordeaux, France.

Department of Hepato-Gastroenterology, Hôpital Trousseau, 37044 Tours, France.

出版信息

Diagn Interv Imaging. 2016 Nov;97(11):1103-1107. doi: 10.1016/j.diii.2016.06.008. Epub 2016 Jul 21.

Abstract

PURPOSE

The purpose of this study was to evaluate the short- and long-term evolution of endoluminal diameter of covered metallic stents that were underdilated at the time of transjugular intrahepatic portosystemic shunt (TIPS) creation.

MATERIEL AND METHODS

Sixteen patients (13 men, 3 women) with a mean age of 57.6years±7.9 (SD) were retrospectively included. All patients had had TIPS creation using a 10-mm diameter covered stent (VIATORR) that was underdilated (i.e., 8mm) at the time of stent placement. Measurements of the mean circulating diameter of the stents were retrospectively performed on angiographic examinations every 6months up to 2years.

RESULTS

The endoluminal stent diameter early enlarged from 8.96mm±1.12 (SD) to 10mm±1.45 (SD) after 6months (P=0.04) with no further significant changes over time after 12months (10.28mm±1.9mm), 18months (9.93±1.51mm) and 24months (9.92±0.9mm).

CONCLUSION

Our results demonstrate a passive expansion of initially underdilated covered stents during the six months following TIPS creation. This should be taken into account regarding hepatic encephalopathy prevention during TIPS placement.

摘要

目的

本研究旨在评估在经颈静脉肝内门体分流术(TIPS)创建时扩张不足的覆膜金属支架管腔内直径的短期和长期演变情况。

材料与方法

回顾性纳入16例患者(13例男性,3例女性),平均年龄57.6岁±7.9(标准差)。所有患者在TIPS创建时均使用了直径10毫米的覆膜支架(VIATORR),该支架在放置时扩张不足(即8毫米)。在长达2年的时间里,每6个月对血管造影检查进行回顾性分析,测量支架的平均循环直径。

结果

6个月后,支架管腔内直径早期从8.96毫米±1.12(标准差)扩大到10毫米±1.45(标准差)(P = 0.04),12个月(10.28毫米±1.9毫米)、18个月(9.93±1.51毫米)和24个月(9.92±0.9毫米)后,随着时间推移无进一步显著变化。

结论

我们的结果表明,在TIPS创建后的六个月内,最初扩张不足的覆膜支架会被动扩张。在TIPS放置过程中预防肝性脑病时应考虑到这一点。

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