Phenprocoumon for prevention of shunt occlusion after transjugular intrahepatic portosystemic stent shunt: a randomized trial

Hepatology : Official Journal of the American Association for the Study of Liver Diseases
P SauerA Stiehl

Abstract

Development of stenosis or occlusion of the transjugular intrahepatic portosystemic stent shunt (TIPSS) is one of the major limiting factors in the long-term viability of this procedure. The efficacy of anticoagulation with heparin which is used in different centers is still unclear. In the present study, we evaluated the effect of phenprocoumon on shunt patency after TIPSS placement using Palmaz stents; 49 patients with Child's A and B cirrhosis, who underwent successful TIPSS placement were randomized into the treatment group (n = 24) who received phenprocoumon and a control group (n = 25). After 11 to 13 weeks, all patients were admitted and had a reevaluation that included control angiography by transjugular approach. Phenprocoumon treatment was stopped after the first reevaluation and both groups were followed for 1 year after randomization. During the 3-month treatment period 11 of 22 patients of the treatment group and 12 of 23 patients of the control group required reintervention because of an increased portosystemic gradient. Five of the 12 patients in the control group showed complete occlusion of the shunt, whereas no occlusion in the treatment group was observed (P < .05). During the mean follow-up of 8 months after...Continue Reading

Citations

Jan 9, 2007·Cardiovascular and Interventional Radiology·Natalia TerreniAndrew K Burroughs
Jun 5, 2007·Cardiovascular and Interventional Radiology·Natalia TerreniAndrew K Burroughs
Jun 17, 1998·Cardiovascular and Interventional Radiology·R JalanD N Redhead
Aug 14, 2012·International Journal of Hepatology·Gilles Pomier-LayrarguesPierre Perreault
Jan 18, 2013·World Journal of Gastroenterology : WJG·Kai LiuXing-Jiang Wu
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