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BioMed Research International
Volume 2016 (2016), Article ID 3681731, 8 pages
http://dx.doi.org/10.1155/2016/3681731
Clinical Study

Pathological Predictors of Shunt Stenosis and Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt

1Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, The 9th Affiliated Hospital of Peking University, Beijing 100038, China
2Department of Plastic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China
3Department of Internal Medicine, Section of Hematology-Oncology, Section of Gastroenterology, Stephenson Cancer Center, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA

Received 14 July 2016; Revised 22 August 2016; Accepted 31 August 2016

Academic Editor: Xingshun Qi

Copyright © 2016 Fuliang He et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Transjugular intrahepatic portosystemic shunt (TIPS) is an artificial channel from the portal vein to the hepatic vein or vena cava for controlling portal vein hypertension. The major drawbacks of TIPS are shunt stenosis and hepatic encephalopathy (HE); previous studies showed that post-TIPS shunt stenosis and HE might be correlated with the pathological features of the liver tissues. Therefore, we analyzed the pathological predictors for clinical outcome, to determine the risk factors for shunt stenosis and HE after TIPS. Methods. We recruited 361 patients who suffered from portal hypertension symptoms and were treated with TIPS from January 2009 to December 2012. Results. Multivariate logistic regression analysis showed that the risk of shunt stenosis was increased with more severe inflammation in the liver tissue (OR, 2.864; 95% CI: 1.466–5.592; ), HE comorbidity (OR, 6.266; 95% CI, 3.141–12.501; ), or higher MELD score (95% CI, 1.298–1.731; ). Higher risk of HE was associated with shunt stenosis comorbidity (OR, 6.266; 95% CI, 3.141–12.501; ), higher stage of the liver fibrosis (OR, 2.431; 95% CI, 1.355–4.359; ), and higher MELD score (95% CI, 1.711–2.406; ). Conclusion. The pathological features can predict individual susceptibility to shunt stenosis and HE.