The Comparison Of Clinical Effect Of Simulative Viatorr With Single Covered Stent Used In TIPS Among Patients With Portal Hypertension Complicated With Upper Gastrointestinal Hemorrhage

Purpose:To study the clinical effects of the simulative Viatorr and the single covered stent in TIPS to treat the portal hypertension with upper gastrointestinal hemorrhage,to explore the mechanism for the development of the postoperative complication,and to determine the feasibility and effectiveness of the simulative Viatorr in TIPS.Methods: From June of 2012 to March of 2015,retrospectively reviewed datas of 49 patients,who had portal hypertension complicated with upper gastrointestinal hemorrhage and were treated with TIPS.26 cases treated with TIPS used by simulative Viatorr stent(trail group);and 23 cases were treated with TIPS used by single covered stent(control group).Two groups were comparable with regared to age,sex,Child-Pugh scales and complications of the portal hypertention.All of the 49 cases were followed up for 6 to 12 months,the outcomes were compared between two groups.Clinical controlled trail between the two groups was conducted.There were no significant differences between sex,age,Child-Pugh scales and complications of the portal hypertention.In the group of the simulative Viatorr,a e PTFE Fluency covered stent(8mmx60mm)was implanted first;according to the balloon incisure,a bare stent(8mmx60mm)was implanted sequentially.In the single covered stent group,the shunt was implanted a ePTFE Fluency covered stent(8mmx60mm)only.The coils were used to embolize the gastric coronary veins routinely in all of the groups.During the six month follow-up period,the recanalization of the shunt was observed by Color Doppler ultrasonography.At the same time,the following events were considered: rebleeding,hepatic encephalopathy,and intractable ascites.Results:1 All TIPS were successful technically both in simulative Viatorr group and in single covered stent group(100%).2 At the 6 months of follow-up,the difference of shunt patency rate3.043% in simulative Viatorr groups and 13.043% in single covered stent groups(P>0.05),the rates of rebleeding in two groups were 7.692% and8.696%(P>0.05),the rates of hepatic encephalopathy were 11.538% and8.696%.There were no obviously statistical difference(P>0.05).3 At the 12 months of follow-up,the rates of shunt patency was a significant difference between the two groups(3.846% vs.30.435%,P<0.05).No difference was observed for the rate of rebleeding(7.692% vs.21.739%,P>0.05),and no difference was observed for the rate of hepatic encephalopathy(11.358% vs.17.391%,P>0.05).Conclusion:The short-term shunt patency of TIPS for portal hypertension complicated with upper gastrointestinal hemorrhage using simulative Viatorr stent is higher than that of using single covered stent.