Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec;16(4):623-632.
doi: 10.5114/wiitm.2021.104198. Epub 2021 Mar 8.

Transjugular intrahepatic portosystemic shunt: a meta-analysis of 8 mm versus 10 mm stents

Ping-Chao Huang  1 , Meng Zhao  2 , Yuan-Yuan Wei  1 , Feng-Fei Xia  1 , Hao Li  3
Affiliations

Transjugular intrahepatic portosystemic shunt: a meta-analysis of 8 mm versus 10 mm stents

Ping-Chao Huang et al. Wideochir Inne Tech Maloinwazyjne. 2021 Dec.

Abstract

Introduction: Transjugular intrahepatic portosystemic shunt (TIPS) is an approach that is used to alleviate portal hypertension-related symptoms. The optimal stent diameter for TIPS remains controversial.

Aim: To assess outcomes in patients who underwent TIPS using 8 mm and 10 mm stents.

Material and methods: The PubMed, Embase, and Cochrane Library databases were queried for all pertinent studies. The meta-analysis was conducted using RevMan v5.3. This meta-analysis was registered at the PROSPERO website (Number: CRD42020212392).

Results: Eighty-two potentially relevant articles were initially detected, with seven of these ultimately being included in this meta-analysis. Patients in the 10 mm stent group exhibited a significantly higher Δportosystemic pressure gradient (ΔPPG) relative to the 8 mm group (p = 0.04), whereas no differences between groups were observed with respect to postoperative hepatic encephalopathy (HE, p = 0.25), re-bleeding (p = 0.82), liver transplantation (p = 0.45), or mortality (p = 0.43) rates. The TIPS dysfunction rate was significant lower in the 10 mm group (p = 0.01). In Asian studies, the postoperative HE rate was found to be significantly lower in the 8 mm group relative to the 10 mm group (p = 0.02), whereas all other endpoints were comparable between these groups. In Western studies, ΔPPG values were significantly greater in the 10 mm group (p < 0.0001), whereas all other endpoint data were comparable between these groups.

Conclusions: TIPS with 10 mm stents provides a lower TIPS dysfunction rate. However, 8 mm stents may be recommended for Asian patients, as they can decrease the risk of postoperative HE.

Keywords: 10 mm; 8 mm; meta-analysis; transjugular intrahepatic portosystemic shunt.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of this study
Figure 2
Figure 2
Risk of bias of the included RCTs
Figure 3
Figure 3
Forest plots showing the comparisons in ΔPPG values (A), post-operative HE (B), TIPS dysfunction (C), re-bleeding (D), liver transplantation (E) and death between 2 groups (F)
See this image and copyright information in PMC

References

    1. Lin J, Liu Q, Liang Z, et al. Laparoscopic selective esophagogastric devascularization and splenectomy for patients with cirrhotic portal hypertension. Videosurgery Miniinv. 2019;14:187–94. - PMC - PubMed
    1. Song T, Rössle M, He F, et al. Transjugular intrahepatic portosystemic shunt for hepatorenal syndrome: a systematic review and meta-analysis. Dig Liver Dis. 2018;50:323–30. - PubMed
    1. Tsauo J, Zhao H, Zhang X, et al. Effect of transjugular intrahepatic portosystemic shunt creation on pulmonary gas exchange in patients with hepatopulmonary syndrome: a prospective study. J Vasc Interv Radiol. 2019;30:170–7. - PubMed
    1. Liu J, Wehrenberg-Klee EP, Bethea ED, et al. Transjugular intrahepatic portosystemic shunt placement for portal hypertension: meta-analysis of safety and efficacy of 8 mm vs. 10 mm Stents. Gastroenterol Res Pract. 2020;2020:9149065. - PMC - PubMed
    1. Lv Y, Qi X, He C, et al. Covered TIPS versus endoscopic band ligation plus propranolol for the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis: a randomised controlled trial. Gut. 2018;67:2156–68. - PubMed