Clinical Study Of Transjugular Intrahepatic Portosystemic Shunt With The Double Stents Technique

Objective:To evaluate the clinical effects of the double stents technique in TIPS treatment.Methods:The clinical data of 32 consecutive patients with portal hypertension treated by TIPS using double stents were retrospectively reviewed. The patients were followed up for 2 weeks to 24 months(mean 11.25±4.3 months). The liver function and portal vein pressure were determined at 3 days,1,3,6 months after the treatment. The results were statistically analyzed.Results:Seventy-five stent-grafts were successfully implanted in 32 patients. The portal vein pressure after treatmentdecreased significantly from(42.68±7.24) cmH2 O to(27.05±4.87) cmH2 O. The difference was statistically significant( P<0.05).Twenty-eight cases with hemorrhage of upper digestive tract due to the portal hypertension was stopped after the treatment. Four cases of the patients were treated due to refractory ascites. One of them, the ascites were significantly reduced in the first week and the others have been relieved within two weeks. During the follow-up period, one case with variceal bleeding secondary to portal vein hypertension died of mutisystem organ failure in 2 weeks. Two cases occluded in the hepatic vein and had another stent-graft implanation. The other 29 cases had no stenosis. Three days after the treatment, the liver functions became deteriorated. At 1, 3,and 6 monthsafter the treatment, the liver functions were not significantly different from those determined before the treatment(P>0.05).Conclusion:The double stents technique can effectively improve the patency rate of shunt and reduce the opportunities for intervention. The hepatic functions will be damaged for a short length of time after TIPS, however, from the viewpoint of the mid- to-long- term results, the hepatic functions are less encroached upon.