Clinical outcome comparison between TIPS and EBL in patients with cirrhosis and portal vein thrombosis

Verfasser / Beitragende:
[Zhu Wang, He Zhao, Xiaoze Wang, Hailong Zhang, Mingshan Jiang, Jiaywei Tsauo, Xuefeng Luo, Li Yang, Xiao Li]
Ort, Verlag, Jahr:
2015
Enthalten in:
Abdominal Imaging, 40/6(2015-08-01), 1813-1820
Format:
Artikel (online)
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024 7 0 |a 10.1007/s00261-014-0320-9  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00261-014-0320-9 
245 0 0 |a Clinical outcome comparison between TIPS and EBL in patients with cirrhosis and portal vein thrombosis  |h [Elektronische Daten]  |c [Zhu Wang, He Zhao, Xiaoze Wang, Hailong Zhang, Mingshan Jiang, Jiaywei Tsauo, Xuefeng Luo, Li Yang, Xiao Li] 
520 3 |a The aim of this study is to compare the clinical outcomes of transjugular intrahepatic portosystemic shunt (TIPS) and endoscopic band ligation (EBL) in patients with cirrhosis and portal vein thrombosis (PVT). We retrospectively reviewed the January to September 2010 data from our database and included 25 patients with cirrhosis and PVT who underwent successful TIPS creation. We selected another 25 patients who underwent EBL matching for age, sex, and Child-Pugh-Turcotte class. The outcome measures included changes in the PVT status before and after the treatments, the rebleeding rate, and the overall survival. The mean follow-up was 25.1±8.7months in the EBL group and 25.6±8.5months in the TIPS group (P=0.85). After treatments, the PVT severity improved in 40% and worsened in 25% of patients who did not undergo TIPS, compared with 87% and none of the patients who underwent TIPS (P<0.001). Previous splenectomy (OR 0.13, 95% CI 0.02-0.76, P=0.024) and patency status of TIPS (OR 20.8, 95% CI 3.0-141.8, P=0.002) were the independent factors associated with PVT disappearance. The 1- and 2-year rebleeding rates were, respectively, 44.6% and 59.0% in the EBL group, and 12.5% and 25.2% in the TIPS group (P=0.002). The 1- and 2-year survival rates were, respectively, 95.7% and 85.2% in the EBL group, and 96% and 78.7% in the TIPS group (P=0.203). The MELD score was the only independent predictive factor for survival (HR 1.73, 95% CI 1.27-2.37, P=0.001). Compared with EBL, TIPS contributed to PVT improvement and reduced the risk of rebleeding without providing a survival benefit for patients with PVT. 
540 |a Springer Science+Business Media New York, 2014 
690 7 |a Portal hypertension  |2 nationallicence 
690 7 |a Variceal bleeding  |2 nationallicence 
690 7 |a Portal vein thrombosis  |2 nationallicence 
700 1 |a Wang  |D Zhu  |u Institution of Intervention Radiology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
700 1 |a Zhao  |D He  |u Department of Gastroenterology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
700 1 |a Wang  |D Xiaoze  |u Department of Gastroenterology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
700 1 |a Zhang  |D Hailong  |u Department of Gastroenterology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
700 1 |a Jiang  |D Mingshan  |u Department of Gastroenterology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
700 1 |a Tsauo  |D Jiaywei  |u Institution of Intervention Radiology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
700 1 |a Luo  |D Xuefeng  |u Institution of Intervention Radiology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
700 1 |a Yang  |D Li  |u Department of Gastroenterology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
700 1 |a Li  |D Xiao  |u Institution of Intervention Radiology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
773 0 |t Abdominal Imaging  |d Springer US; http://www.springer-ny.com  |g 40/6(2015-08-01), 1813-1820  |x 0942-8925  |q 40:6<1813  |1 2015  |2 40  |o 261 
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900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
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950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00261-014-0320-9  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Wang  |D Zhu  |u Institution of Intervention Radiology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Zhao  |D He  |u Department of Gastroenterology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Wang  |D Xiaoze  |u Department of Gastroenterology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Zhang  |D Hailong  |u Department of Gastroenterology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Jiang  |D Mingshan  |u Department of Gastroenterology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Tsauo  |D Jiaywei  |u Institution of Intervention Radiology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Luo  |D Xuefeng  |u Institution of Intervention Radiology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Yang  |D Li  |u Department of Gastroenterology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Li  |D Xiao  |u Institution of Intervention Radiology, West China Hospital, Sichuan University, 37# Guoxue Lane, 610041, Chengdu, Sichuan, China  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Abdominal Imaging  |d Springer US; http://www.springer-ny.com  |g 40/6(2015-08-01), 1813-1820  |x 0942-8925  |q 40:6<1813  |1 2015  |2 40  |o 261