A Clinical Study Of Transjugular Intrahepatic Portal Shunt In Portal Hypertension Patients With Different Types Of Portal Vein Thrombosis

Objective To compare the difference of shunt failure rate and its influencing factors in portal hypertension patients with different types of portal vein thrombosis after transjugular intrahepatic portosystemic shunt.Methods Patients with portal vein thrombosis and Ningxia Medical University portal hypertension from January 1,2015 to December 31,2020 were recruited,according to the inclusion and exclusion criteria,a total of 147 patients were enrolled and basic information of patients was collected,including name,sex and age,the clinical data included stent type,laboratory parameters,splenectomy or not,portal vein pressure during operation and so on.The end point was stent failure,the time point was 2 years after operation,statistical different groups of stent failure rate,shunt failure factors of single factor analysis,will be meaningful indicators of multi-factor analysis to find the factors affecting the shunt failure.Results(1)The patients were divided into I,II,III,IV and V types according to the location of the thrombus.After univariate analysis,the failure rate of shunt was p = 0,p <0.05;The failure rate of type III and Type V was higher than that of type I and Type II,and only 2 cases of type IV were found,the patients were divided into VIATORR stent group,covered stent combined with bare stent group and covered stent group,the patency rate of stent with Viatorr was higher than that with bare stent and covered stent alone.(3)in this study,there was significant difference in the patency rate of stent with Viatorr compared with bare stent and covered stent alone,age,WBC,RBC,PLT,HGB,ALT,AST,CREA,TBIL,APTT,INR,D-2imer,FIB,Child-Pug scores,preoperative portal pressure,postoperative portal pressure were included,sex,different types of portal vein thrombosis,type of stent,splenectomy,location of portal vein puncture were included in the data,different types of portal vein thrombosis(p = 0.00),splenectomy(P = 0.00),Stent Type(p = 0.00);PLT(P =0.00),D-2imer(P = 0.00)in the data;Type III portal vein thrombosis(p = 0.00),Type V portal vein thrombosis(p = 0.00),splenectomy(p = 0.002),simple covered stent(p = 0.001),D-2imer(P = 0.00),p LT(p = 0.027)was associated with stent failure.Conclusions 1.For patients with portal vein thrombosis,if the thrombus developed to Type III,V,the failure rate of shunt was higher after operation2.For the long-term patency rate of stent,Viatorr stent was better than coated stent and bare stent was better than pure coated stent.3.Splenectomy,increased platelet count and D-2 polymers can affect postoperative stent patency.