Rossi P, Bezzi M, Salvatori F M, Broglia L, Maccioni F, Pizzi G, Abbondanza S, Bonomo G
Department of Radiology, University of Rome La Sapienza, Policlinico Umberto I, Italy.
Eur Radiol. 1996;6(5):741-7. doi: 10.1007/BF00187682.
The aim of our study was to evaluate the performance and efficacy of a new self-expanding stent (nitinol Strecker stent) in the transjugular intrahepatic portosystemic shunt (TIPS) procedure. We have successfully placed 64 nitinol Strecker stents in 48 patients. The average portosystemic gradient decreased from 22 to 11 mm Hg. Balloon dilatation was necessary in 12 of 35 angiographically controlled cases at 5 days (34%), because of incomplete stent expansion, small thrombi within the stent or obstruction. At 1-6 months stent malfunctions occurred in 8 of 23 patients who underwent control angiography (34%) and at 6-24 months in 6 of 7 patients (85%). Rebleeding occurred in 2 of 39 patients (follow-up > 1 month) (5%) and temporary crises of de novo encephalopathy were observed in 11 of 48 patients (23%). Refractory ascites completely resolved in 4 of 6 patients (66%) and improved in the remaining 2 cases. Compared with other self-expanding stents, nitinol Strecker stents seem to be equally effective in TIPS; no increase in complication rate was observed, either clinical or stent-related.
我们研究的目的是评估一种新型自膨式支架（镍钛诺Strecker支架）在经颈静脉肝内门体分流术（TIPS）中的性能和疗效。我们已成功地为48例患者置入了64枚镍钛诺Strecker支架。门体平均压差从22毫米汞柱降至11毫米汞柱。在35例血管造影监测的病例中，有12例（34%）在术后5天时因支架扩张不完全、支架内小血栓形成或阻塞而需要球囊扩张。在接受对照血管造影的23例患者中，有8例（34%）在1至6个月时出现支架故障，在7例患者中的6例（85%）在6至24个月时出现支架故障。39例患者中有2例（随访时间>1个月）（5%）再次出血，48例患者中有11例（23%）出现新发脑病的短暂发作。6例患者中有4例（66%）难治性腹水完全消退，其余2例有所改善。与其他自膨式支架相比，镍钛诺Strecker支架在TIPS中似乎同样有效；未观察到临床或与支架相关的并发症发生率增加。
