Gastroenterology Department II, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, Yunnan, China.
Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, Yunnan, China.
Cardiovasc Intervent Radiol. 2022 May;45(5):552-562. doi: 10.1007/s00270-022-03102-5. Epub 2022 Mar 10.
To investigate the effects of transjugular intrahepatic portosystemic shunt (TIPS) creation using Fluency versus Viatorr stent-grafts on the long-term clinical outcomes.
This was a single-center retrospective study from January 2010 to October 2021 in 213 patients receiving TIPS with Fluency (Fluency group, n = 154) versus Viatorr (Viatorr group, n = 59) stent-grafts. Inclusion criteria were: age > 18 years old and TIPS creation for variceal hemorrhage. Exclusion criteria were: age > 80 years old, concomitant chronic heart or lung disease, active tuberculosis or human immunodeficiency virus infection, extrahepatic malignancy, alcohol dependence, TIPS created outside of our hospital, without any follow-up data, or decline to participate. The primary outcome was primary patency rate and its associated risk factors.
The 5-year cumulative primary patency rate was significantly higher in Viatorr group than in Fluency group (89.0% vs. 19.6%, p < 0.001), whereas the 5-year cumulative transplant-free survival rate (62.3% vs. 62.2%, p = 0.636) was comparable between two groups. Cox-regression models revealed that group (hazard ratio [HR]4.029, 95% confidence interval [CI] 1.486-10.927, p = 0.006), use of bare stents (HR 3.307, 95% CI 1.903-5.747, p < 0.001), and baseline portal vein thrombosis (HR 0.248, 95% CI 0.149-0.412, p < 0.001) were significantly associated with shunt patency. Incidences of adverse events were not significantly different between two groups (p > 0.05).
TIPS creation using Viatorr stent-grafts is superior to using Fluency stent-grafts in terms of higher long-term primary patency rate but similar transplant-free survival rate.
研究使用 Fluency 与 Viatorr 支架行经颈静脉肝内门体分流术（TIPS）对长期临床结果的影响。
这是一项单中心回顾性研究，纳入 2010 年 1 月至 2021 年 10 月在我院接受 TIPS 的 213 例患者，其中使用 Fluency（Fluency 组，n=154）与 Viatorr（Viatorr 组，n=59）支架。纳入标准为：年龄＞18 岁且因静脉曲张出血而行 TIPS。排除标准为：年龄＞80 岁、合并慢性心肺疾病、活动性肺结核或人类免疫缺陷病毒感染、肝外恶性肿瘤、酒精依赖、TIPS 非在我院创建、无任何随访数据或拒绝参与。主要结局为初始通畅率及其相关的危险因素。
Viatorr 组的 5 年累积初始通畅率显著高于 Fluency 组（89.0%比 19.6%，p＜0.001），而两组的 5 年无移植生存率（62.3%比 62.2%，p=0.636）相似。Cox 回归模型显示，分组（风险比[HR]4.029，95%置信区间[CI]1.486-10.927，p=0.006）、使用裸支架（HR 3.307，95%CI 1.903-5.747，p＜0.001）和基线门静脉血栓形成（HR 0.248，95%CI 0.149-0.412，p＜0.001）与分流通畅显著相关。两组不良事件发生率无显著差异（p＞0.05）。
与 Fluency 支架相比，使用 Viatorr 支架行 TIPS 具有更高的长期初始通畅率，但无移植生存率相似。
