Analysis Of Risk Factors For Restenosis After TIPS And The Efficacy Of New Stent-graft

Objective: To investigate the risk factors for stent restenosis after TIPS and to compare the efficacy of new stent grafts with stents.Materials and Methods: The clinical data of 133 patients with TIPS who were admitted to Hunan Provincial People's Hospital from January 2015 to December 2017 were retrospectively analyzed.First,the cox regression model was used to analyz the possible variables affecting restenosis after TIPS.The selected variables were analyzed by COX regression model for multivariate analysis of independent risk factors for restenosis after TIPS.The changes of portal pressure gradient(PPG),hepatic encephalopathy(HE),stent patency rate and patient survival rate were compared between the two groups of patients who underwent TIPS with new stent graft and combined stent stent.Result:1.A total of 133 patients were enrolled in the study,with a follow-up of 1-48 months and a median follow-up of 12 months.Univariate and multivariate analysis of risk factors for restenosis after TIPS were performed.The results showed that the history of spleen resection or embolization(P<0.05)was statistically significant.2.After TIPS,in 133 patients,the portal pressure decreased from an average of 33.49±5.54cmH2 O to an average of 20.92±4.23cmH2O(P<0.01).A total of 44 patients underwent TIPS with a new stent graft,and 89 patients underwent TIPS with a combined stent.After the successful establishment of the shunt,the comparison between the two: portal vein pressure decreased(12.65±3.54cmH2 O vs 12.57±2.13cmH2 O,P>0.05);the incidence of cumulative hepatic encephalopathy after 3 months(15.9% vs 18.0%,P> 0.05);the incidence of cumulative hepatic encephalopathy 1 year after operation(22.7% vs 28.5%,P>0.05);cumulative stent patency rate after 1 year(94%% vs 86.2%,P>0.05);postoperative 1 The cumulative survival rate was(89.8% vs 90.1%,P>0.05).There was no statistical difference.Conclusion:1.Preoperative spleen resection or embolization history may be an independent risk factor for restenosis after TIPS;2.The use of a new stent graft and a combined stent for TIPS,both confirming the short-term effectiveness of treatment for portal hypertension and showing safety in practical clinical applications.