Retrospective evaluation of early thrombosis in transjugular intrahepatic portosystemic polytetrafluoroethylene-coated shunts under 2-day postinterventional heparinization.


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
22 06 2022
Historique:
received: 19 11 2021
accepted: 06 06 2022
entrez: 22 6 2022
pubmed: 23 6 2022
medline: 25 6 2022
Statut: epublish

Résumé

The development of acute thrombosis within the TIPS tract may be prevented by prophylactic anticoagulation; however, there is no evidence of the correct anticoagulation regimen after TIPS placement. The purpose of this single-center retrospective study was to evaluate the short-term occlusion rate of transjugular intrahepatic portosystemic shunts (TIPSs) with polytetrafluorethylene (PTFE)-coated stents under consequent periprocedural full heparinization (target partial thromboplastin time [PTT]: 60-80 s). We analyzed TIPS placements that were followed up over a six-month period by Doppler ultrasound in 94 patients and compared the study group of 54 patients who received intravenous periprocedural full heparinization (target PTT: 60-80 s) without any other anticoagulation to patients with prolonged anticoagulation medication. The primary endpoint was TIPS patency after six months. The primary patency rate was 88.3% overall, and in the study group, 90.7%, with an early thrombosis rate of 3.2% (study group: 1.9%) and a primary assisted patency rate of 95.7% (study group: 96.3%). In the study group, one case of TIPS thrombosis occurred on the 23rd day after TIPS placement. Two patients underwent reintervention because of stenosis or buckling. Moreover, the target PTT was not attained in 8 of the 54 patent TIPSs. Four patients had an increased portosystemic pressure gradient, without stenosis, and the flow rate was corrected by increasing the TIPS diameter by dilation. Two-day heparinization seems sufficient to avoid early TIPS thrombosis over a six-month period.

Identifiants

pubmed: 35732875
doi: 10.1038/s41598-022-14388-3
pii: 10.1038/s41598-022-14388-3
pmc: PMC9217914
doi:

Substances chimiques

Anticoagulants 0
Polytetrafluoroethylene 9002-84-0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

10506

Informations de copyright

© 2022. The Author(s).

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Auteurs

Holger Goessmann (H)

Department of Diagnostic and Interventional Radiology, University of Leipzig Medical Center, Leipzig, Germany.
Department of Radiology, University Hospital Regensburg, 93042, Regensburg, Germany.

Verna Schuffenhauer (V)

Department of Radiology, University Hospital Regensburg, 93042, Regensburg, Germany.

Arne Kandulski (A)

Department of Internal Medicine I, Gastroenterology, Endocrinology, Rheumatology, and Infectious Diseases, Regensburg University Hospital, Regensburg, Germany.

Kilian Weigand (K)

Department of Internal Medicine I, Gastroenterology, Endocrinology, Rheumatology, and Infectious Diseases, Regensburg University Hospital, Regensburg, Germany.

Ernst-Michael Jung (EM)

Department of Radiology, University Hospital Regensburg, 93042, Regensburg, Germany.

Wibke Uller (W)

Department of Radiology, University Hospital Regensburg, 93042, Regensburg, Germany.
Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center University of Freiburg, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.

Gregor Scharf (G)

Department of Radiology, University Hospital Regensburg, 93042, Regensburg, Germany.

Cristian Stroszczynski (C)

Department of Radiology, University Hospital Regensburg, 93042, Regensburg, Germany.

Niklas Verloh (N)

Department of Radiology, University Hospital Regensburg, 93042, Regensburg, Germany. niklas.verloh@ukr.de.
Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center University of Freiburg, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany. niklas.verloh@ukr.de.

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