Systematic review and meta-analysis of trans-jugular intrahepatic portosystemic shunt for cirrhotic patients with portal vein thrombosis  

作　　者：Jian-Bin Zhang Jie Chen Jin Zhou Xu-Ming Wang Shu Chen Jian-Guo Chu Peng Liu Zhi-Dong Ye 

机构地区：[1]Department of Cardiovascular Surgery,China-Japan Friendship Hospital,Beijing 100029,China [2]Department of Interventional Radiology,Affiliated People’s Hospital of Inner Mongolia Medical University,Hohhot 010020,Inner Mongolia Autonomous Region,China [3]Department of Radiology,Air Force Medical Center of PLA,Beijing 100142,China

出　　处：《World Journal of Clinical Cases》2021年第19期5179-5190,共12页世界临床病例杂志

摘　　要：BACKGROUND Portal vein thrombosis(PVT)was previously a contraindication for trans-jugular intrahepatic portosystemic shunt(TIPS).AIM To perform a systematic review and meta-analysis of the current available studies investigating outcomes of TIPS for cirrhotic patient with PVT.METHODS Multiple databases were systematically searched to identify studies investigating the outcomes of TIPS for cirrhotic patients with PVT.The quality of studies was assessed by Cochrane Collaboration method and Methodological Index for Non-Randomized Studies.The demographic data,outcomes,combined treatment,and anticoagulation strategy were extracted.RESULTS Twelve studies were identified with 460 patients enrolled in the analysis.The technical success rate was 98.9%in patients without portal vein cavernous transformation and 92.3%in patients with portal vein cavernous transformation.One-year portal vein recanalization rate was 77.7%,and TIPS patency rate was 84.2%.The cumulative encephalopathy rate was 16.4%.One-year overall survival was 87.4%.CONCLUSION TIPS is indicated for portal hypertension related complications and the restoration of pre-transplantation portal vein patency in cirrhotic patients with PVT.Cavernous transfor-mation is an indicator for technical failure.Post-TIPS anticoagulation seems not mandatory.Simultaneous TIPS and percutaneous mechanical thrombectomy device could achieve accelerated portal vein recanalization and decreased thrombolysis-associated complications,but further investigation is still needed.

关 键 词：Trans-jugular intrahepatic portosystemic shunt Portal vein thrombosis Liver cirrhosis Systematic review META-ANALYSIS 

分 类 号：R657.3[医药卫生—外科学]