Efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) created using covered stents of different diameters: A systematic review and meta-analysis - 28/04/21
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Highlights |
• | A meta-analysis was performed to compare the clinical efficacy of TIPS using 8mm covered stents to that using 10mm diameter covered stents in patients with liver cirrhosis. |
• | The 8mm covered stent group had greater one-year (odds ratio [OR], 2.88; P=0.003) and three-year overall survival (OR, 1.81; P=0.04) and lower hepatic encephalopathy rate (OR, 0.69; P=0.04) compared to 10mm covered stent group. |
• | No significant differences in variceal rebleeding (OR, 0.80; P=0.67) was found between the two stents but shunt dysfunction rate was lower in 10mm covered stent group (OR, 2.26; P=0.003). |
Abstract |
Purpose |
The purpose of this study was to make a systematic review and meta-analysis to determine the stent diameter (8mm vs. 10mm) that conveys better safety and clinical efficacy for transjugular intrahepatic portosystemic shunt (TIPS).
Materials and methods |
Four databases were used to identify clinical trials published from inception until March 2020. Data were extracted to estimate and compare one-year and three-year overall survivals, hepatic encephalopathy, variceal rebleeding, and shunt dysfunction rates between patients with 8mm covered stents and those with 10mm covered stents.
Results |
Five eligible studies were selected, which included 489 patients (316 men, 173 women). The 8mm covered stent group had higher efficacy regarding one-year or three-year overall survival (odds ratio [OR], 2.88; P=0.003) and (OR, 1.81; P=0.04) and lower hepatic encephalopathy (OR, 0.69; P=0.04) compared with 10mm covered stent group. There were no significant differences in variceal rebleeding rate (OR 0.80; P=0.67). However, shunt dysfunction was lower in 10mm covered stent group (OR, 2.26; P=0.003).
Conclusions |
Our results suggest that the use of 8mm covered stents should be preferred to that of 10mm covered stents for TIPS placement when portal pressure is frequently monitored.
Le texte complet de cet article est disponible en PDF.Keywords : Hepatic encephalopathy, Portosystemic shunt, Transjugular intrahepatic (TIPS), Overall survival, Stents diameter, Meta-analysis
Abbreviations : CI, HE, HR, OR, OS, PRISMA-P, NOS, PTFE-covered, RCT, RR, TIPS
Plan
Vol 102 - N° 5
P. 279-285 - mai 2021 Retour au numéro
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