@misc{10481/108177,
year = {2025},
month = {11},
url = {https://hdl.handle.net/10481/108177},
abstract = {Background: Transjugular intrahepatic portosystemic shunt (TIPS) has emerged as a
feasible therapeutic option for cirrhotic patients with portal vein thrombosis (PVT). This
study aimed to assess the long-term outcomes and factors associated with TIPS dysfunction
in cirrhotic patients with PVT over an 18-year period in our institution. Methods: A
retrospective study was conducted at Hospital Universitario Reina Sofía (Córdoba, Spain),
including adult and pediatric cirrhotic patients with PVT who underwent TIPS between
January 2006 and December 2024. Patient characteristics, procedural techniques, and
clinical outcomes were evaluated. The primary outcomes were TIPS insertion success rate,
primary patency, and dysfunction (stenosis or occlusion). Bivariate comparisons, logistic
regression and receiver-operating characteristic (ROC) analyses were performed to identify
potential predictors of TIPS dysfunction. Survival analyses using the Kaplan–Meier method
and log-rank test, complemented by Cox regression, were also conducted. Results: A total
of 36 patients (mean age, 44.8 ± 20.1 years old; 22.2% women; 19.4% children) were
included, with a mean follow-up of 66.3 ± 45.9 months and nine deaths (one attributable to
the procedure). The primary success rate of TIPS placement was 100%, and mean primary
patency was 40.3 ± 40.2 months. TIPS dysfunction occurred in 30.3% of patients. Logistic
regression identified age as the only significant predictor of TIPS dysfunction (OR = 0.949;
95%CI, 0.907–0.985, p = 0.011). ROC analysis demonstrated an AUC of 0.737 (95%CI,
0.547–0.927), with an optimal age cut-off of 21 (equivalent to 18 years; sensitivity = 91.3%,
specificity = 50%). When age was dichotomized into adult versus pediatric groups, the
OR was 0.095 (95%CI, 0.011–0.560), consistent with survival analyses (log-rank p = 0.007;
HR = 4.85; 95%CI 1.36–16.88, p = 0.015). Conclusions: TIPS is an effective treatment
for cirrhotic patients with PVT, achieving high technical success and long-term patency.
However, it is not exempt from complications, including death, and potential dysfunction
remains a concern, particularly in pediatric patients. Further prospective studies with
larger cohorts are warranted to refine patient selection and optimize outcomes.},
publisher = {MDPI},
keywords = {Portal vein thrombosis},
keywords = {Transjugular intrahepatic portosystemic shunt},
keywords = {Liver cirrhosis},
title = {Transjugular Intrahepatic Portosystemic Shunt for Portal Vein Thrombosis in Cirrhotic Patients: 18-Year Experience in a Tertiary Referral Hospital},
doi = {10.3390/diagnostics15222878},
author = {Barranco Acosta, Sara and Lombardo Galera, María Sagrario and García Jurado, Pedro Blas and Pérez Montilla, María Eugenia and Laínez Ramos-Bossini, Antonio Jesús and Espejo Herrero, Juan José},
}