Patency and clinical outcomes of transjugular intrahepatic portosystemic shunt with polytetrafluoroethylene-covered stents versus bare stents: A meta-analysis
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作者:
Yang, Zhiping
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Fourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R ChinaFourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R China
Yang, Zhiping
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Han, Guohong
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Fourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R ChinaFourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R China
Han, Guohong
[1
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Wu, Qiong
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Fourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R ChinaFourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R China
Wu, Qiong
[1
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Ye, Xiaofei
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Second Mil Med Univ, Dept Hlth Stat, Shanghai, Peoples R ChinaFourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R China
Ye, Xiaofei
[2
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Jin, Zhichao
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Second Mil Med Univ, Dept Hlth Stat, Shanghai, Peoples R ChinaFourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R China
Jin, Zhichao
[2
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Yin, Zhanxin
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Fourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R ChinaFourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R China
Yin, Zhanxin
[1
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Qi, Xingshun
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Fourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R ChinaFourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R China
Qi, Xingshun
[1
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Bai, Ming
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Fourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R ChinaFourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R China
Bai, Ming
[1
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Wu, Kaichun
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Fourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R ChinaFourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R China
Wu, Kaichun
[1
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Fan, Daiming
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Fourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R ChinaFourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R China
Fan, Daiming
[1
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机构:
[1] Fourth Mil Med Univ, Xijing Hosp Digest Dis, Xian 710032, Peoples R China
[2] Second Mil Med Univ, Dept Hlth Stat, Shanghai, Peoples R China
Background and Aim: Transjugular intrahepatic portosystemic shunt (TIPS) with polytetrafluoroethylene-(PTFE)-covered stent has been increasingly used for patients with complications of portal hypertension. It is still debated whether the new endoprostheses will improve some clinical outcomes (except for shunt patency) compared to the bare stents. The aims of our meta-analysis were to explore the patency and clinical outcomes of TIPS with PTFE-covered stent-grafts versus bare stents. Methods: Pertinent studies were retrieved through PubMed (1950-2010), MEDLINE (1950-2010), and reference lists of key articles. Outcome measures were primary patency, risk of encephalopathy and survival. Time-to-event data analysis was used to calculate the overall hazard ratios (HR). Results: Six studies were identified including a total of 1275 patients (346 TIPS with PTFE-covered stent-grafts and 929 TIPS with bare stents). Pooled shunt patency data from four eligible studies suggested a significant improvement of primary patency in patients who were treated with PTFE-covered stent-grafts (HR = 0.28, 95% confidence interval [CI] 0.20-0.35). Pooled encephalopathy data from three eligible studies suggested a significant reduction of risk in the PTFE-covered group (HR = 0.65, 95%CI 0.45-0.86). Pooled survival data from four eligible studies also suggested a significant decrease of mortality in the PTFE-covered group (HR = 0.76, 95%CI 0.58-0.94). No statistical heterogeneity was observed between studies for either outcome. Conclusions: This meta-analysis shows that the use of PTFE-covered stent-grafts clearly improves shunt patency without increasing the risk of hepatic encephalopathy and with a trend towards better survival.
机构:
Sichuan Univ, West China Hosp, Dept Gastroenterol & Hepatol, 37 Guoxue Lane, Chengdu 610041, Sichuan, Peoples R ChinaSichuan Univ, West China Hosp, Dept Gastroenterol & Hepatol, 37 Guoxue Lane, Chengdu 610041, Sichuan, Peoples R China
Wang, Xiaoze
Luo, Xuefeng
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Sichuan Univ, West China Hosp, Dept Gastroenterol & Hepatol, 37 Guoxue Lane, Chengdu 610041, Sichuan, Peoples R ChinaSichuan Univ, West China Hosp, Dept Gastroenterol & Hepatol, 37 Guoxue Lane, Chengdu 610041, Sichuan, Peoples R China
Luo, Xuefeng
Zhao, Ming
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机构:
Sichuan Univ, West China Hosp, Dept Gastroenterol & Hepatol, 37 Guoxue Lane, Chengdu 610041, Sichuan, Peoples R ChinaSichuan Univ, West China Hosp, Dept Gastroenterol & Hepatol, 37 Guoxue Lane, Chengdu 610041, Sichuan, Peoples R China
Zhao, Ming
Song, Jinlei
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机构:
Sichuan Univ, West China Hosp, Dept Gastroenterol & Hepatol, 37 Guoxue Lane, Chengdu 610041, Sichuan, Peoples R ChinaSichuan Univ, West China Hosp, Dept Gastroenterol & Hepatol, 37 Guoxue Lane, Chengdu 610041, Sichuan, Peoples R China
Song, Jinlei
Li, Xiao
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机构:
Chinese Acad Med Sci & Peking Union Med Coll, Natl Canc Ctr, Dept Intervent Therapy, Beijing 100021, Peoples R China
Chinese Acad Med Sci & Peking Union Med Coll, Canc Hosp, Beijing 100021, Peoples R ChinaSichuan Univ, West China Hosp, Dept Gastroenterol & Hepatol, 37 Guoxue Lane, Chengdu 610041, Sichuan, Peoples R China
Li, Xiao
Yang, Li
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Sichuan Univ, West China Hosp, Dept Gastroenterol & Hepatol, 37 Guoxue Lane, Chengdu 610041, Sichuan, Peoples R ChinaSichuan Univ, West China Hosp, Dept Gastroenterol & Hepatol, 37 Guoxue Lane, Chengdu 610041, Sichuan, Peoples R China