Researchers from Barcelona, Spain, investigated the long-term effect of transjugular intrahepatic portosystemic shunt (TIPS) on patients with Budd-Chiari syndrome (BCS).
A total of 21 patients with BCS, consecutively admitted to the team's unit, were evaluated and followed up for a mean of 4 years.
Of these, 7 patients had non-progressive forms of BCS and were successfully controlled with medical therapy. One case, with a short-length hepatic vein stenosis, was successfully treated by angioplasty. All 8 patients were alive and asymptomatic at the time of the research being published.
The remaining 13 patients had a TIPS because of clinical deterioration, which was followed by an improvement in clinical condition.
However, a patient with fulminant liver failure before TIPS insertion died 4 months later. Another patient with cirrhosis at diagnosis had liver transplantation 2 years later.
| TIPS was associated with long-term survival in patients with Budd-Chiari syndrome.
| Hepatology |
The remaining 11 patients were still alive and free of ascites.
In 3 of these patients, TIPS was patent after 3, 6, and 12 months.
The team found that the remaining 8 patients developed late TIPS dysfunction. In 2 of these cases, after angioplasty and restenting, TIPS was patent after a follow-up of 9 and 80 months.
In 5 other patients, recurring TIPS occlusion was not further corrected because no signs of portal hypertension were present.
Antonia Perelló, of the Liver Unit at the Institut de Malalties Digestives, University of Barcelona, concluded on behalf of fellow authors, "In patients with BCS uncontrolled with medical therapy, TIPS is a highly effective technique that is associated with long-term survival."