Year 2021 / Volume 113 / Number 1
Original
Transjugular intrahepatic portosystemic shunt (TIPS) in Spain. Clinical-epidemiological considerations in relation to a multicenter registry

23-27

DOI: 10.17235/reed.2020.6783/2019

José A. Guirola, Santiago Gil, Luis Zurera, Mikel Echenegusia, Javier Blázquez, Javier Guerrero, José Urbano, Miguel Ángel de Gregorio, Antonio Capel on behalf of Grupo para el estudio del TIPS en España (GETIPSE)*,

* Grupo para el estudio del TIPS en España (GETIPSE): Antonio Capel, Abel Gregorio, Mercedes Perez, Manuel Trillo, Jose Echevarria, Jesus Aldea, Jose J Muñoz, Carlos Lanciego, María Dolores Ferrer , José Ramon Pulpeiro, Jaume Sampere, Joan Falco

Abstract
Objective: this study aimed to determine the epidemiological, technical and clinical data of transjugular intrahepatic portosystemic shunt (TIPS) performed by Interventional Radiology departments in Spain. Furthermore, the total number of TIPS carried out in Spain was determined and compared with other countries. Material and methods: a retrospective study was performed with the approval of the Ethical Committee of the Spanish Society of Interventional Radiology (SERVEI). A survey was performed with 31 items (demographic, technical and clinical data) for data acquisition on the current status of TIPS in Spain. The survey was sent to the 49 hospitals that SERVEI included in a previous registry with data of TIPS performed in Spain in 2016. Results: of the 49 centers surveyed, 33 (67.35 %) replied to the survey. These centers had completed 265 of the 415 TIPS that year in Spain. The most frequent indication was upper GI bleeding from gastroesophageal varices, which accounted for 144 (54.33 %); 62.26 % of the TIPS were performed urgently and 37.7 % on a scheduled basis. The technical success was 89.16 ± 20.9 %, with a rebleeding rate of 17.9 %. Sixty-nine patients (26.03 %) presented complications, 19.62 % of them minor and 6.41 % major. The 30-day mortality related to the disease was 14.33 %, while mortality at one year was 18.49 %. Conclusion: notably in our study, the complications of TIPS did not show a clear relationship with the number of procedures performed. With regard to other countries like the United States and France, the number of TIPS in Spain per million inhabitants is currently substantially lower. There were no significant changes compared to the number completed in 2013.
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References
1. Richter GM, Palmaz JC, Nöldge G , et al. [The transjugular intrahepatic portosystemic stent-shunt. A new nonsurgical percutaneous method]. Radiologe. 1989; 29 (8):406–411.
2. Rösch J. Development of transjugular intrahepatic portosystemic shunt. J Vasc Interv Radiol JVIR. 2015; 26(2):220–222.
3. Pubmed: “Portasystemic Shunt, Transjugular Intrahepatic”[Mesh] [Internet]. 2019. Available from https://www.ncbi.nlm.nih.gov/pubmed?term=%22Portasystemic+Shunt%2C+Transjugular+Intrahepatic%22%5BMesh%5D
4. Maynar M, Cabrera J, Pulido-Duque J, et al. Transjugular intrahepatic portosystemic shunt: early experience with a flexible trocar/catheter system. AJR Am J Roentgenol. 1993; 161(3):301–306.
5. Brunner F, Berzigotti A, Bosch J. Prevention and treatment of variceal haemorrhage in 2017. Liver Int Off J Int Assoc Study Liver. 2017; 37 Suppl 1:104–15.
6. Boyer TD, Haskal ZJ. American Association for the Study of Liver Diseases. The Role of Transjugular Intrahepatic Portosystemic Shunt (TIPS) in the Management of Portal Hypertension: update 2009. Hepatol Baltim Md. 2010; 51(1):306.
7. Fagiuoli S, Bruno R, Debernardi Venon W, et al. Consensus conference on TIPS management: Techniques, indications, contraindications. Dig Liver Dis Off J Ital Soc Gastroenterol Ital Assoc Study Liver. 2017; 49(2):121–137.
8. García-Pagán JC, Caca K, Bureau C, et al. Early use of TIPS in patients with cirrhosis and variceal bleeding. N Engl J Med. 2010; 362(25):2370–2379.
9. Weil D, Cervoni J-P, Fares N, et al. Management of gastric varices: a French national survey. Eur J Gastroenterol Hepatol. 2016; 28(5):576–581.
10. Njei B, McCarty TR, Laine L. Early transjugular intrahepatic portosystemic shunt in US patients hospitalized with acute esophageal variceal bleeding. J Gastroenterol Hepatol. 2017; 32(4):852–858.
11. Urbano J, de Gregorio MA. The Strategic Plan of Spanish Society of Vascular and Interventional Radiology. Cardiovasc Intervent Radiol. 2019; 42(4):632–635.
12. Datos de actividad totales | Sociedad Española de Radiología Vascular e Intervencionista (SERVEI) [Internet]. [cited 2019 Jun 11]. Available from: https://servei.org/datos-de-actividad-totales/
13. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. STROBE initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg. 2014; 12(12):1495-1499.
14. Khalilzadeh O, Baerlocher MO, Shyn PB, et al. Proposal of a New Adverse Event Classification by the Society of Interventional Radiology Standards of Practice Committee. J Vasc Interv Radiol JVIR. 2017; 28 (10):1432-1437.e3.
15. Monescillo A, Martínez-Lagares F, Ruiz-del-Arbol L, et al. Influence of portal hypertension and its early decompression by TIPS placement on the outcome of variceal bleeding. Hepatol Baltim Md. 2004; 40 (4):793–801.
16. Cello JP, Ring EJ, Olcott EW, et al. Endoscopic sclerotherapy compared with percutaneous transjugular intrahepatic portosystemic shunt after initial sclerotherapy in patients with acute variceal hemorrhage. A randomized, controlled trial. Ann Intern Med. 1997; 126(11):858–65.
17. Garcia-Pagán JC, Di Pascoli M, Caca K, et al. Use of early-TIPS for high-risk variceal bleeding: results of a post-RCT surveillance study. J Hepatol. 2013; 58(1):45–50.
18. Bucsics T, Schoder M, Diermayr M, et al. Transjugular intrahepatic portosystemic shunts (TIPS) for the prevention of variceal re-bleeding – A two decades experience. PLoS ONE 2018 9;13(1) e0189414
19. Trivedi PS, Rochon PJ, Durham JD, Ryu RK. National Trends and Outcomes of Transjugular Intrahepatic Portosystemic Shunt Creation Using the Nationwide Inpatient Sample. J Vasc Interv Radiol JVIR. 2016; 27(6):838–845.
20. Sarwar A, Zhou L, Novack V, et al. Hospital volume and mortality after transjugular intrahepatic portosystemic shunt creation in the United States. Hepatol Baltim Md. 2018,67(2):690-699
21. Yonker-Sell AE, Connolly LA. Mortality during transjugular intrahepatic portosystemic shunt placement. Anesthesiology. 1996; 84 (1):231–3.
22. Siramolpiwat S. Transjugular intrahepatic portosystemic shunts and portal hypertension-related complications. World J Gastroenterol WJG. 2014; 20(45):16996–7010.
23. Pomier-Layrargues G, Bouchard L, Lafortune M, Bissonnette J, Guérette D, Perreault P. The transjugular intrahepatic portosystemic shunt in the treatment of portal hypertension: current status. Int J Hepatol. 2012; 2012:167868.
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Guirola J, Gil S, Zurera L, Echenegusia M, Blázquez J, Guerrero J, et all. Transjugular intrahepatic portosystemic shunt (TIPS) in Spain. Clinical-epidemiological considerations in relation to a multicenter registry. 6783/2019


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Publication history

Received: 01/12/2019

Accepted: 20/02/2020

Online First: 23/11/2020

Published: 11/01/2021

Article revision time: 72 days

Article Online First time: 358 days

Article editing time: 407 days


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