IS THE TANTALUM STRECKER STENT SUITABLE FOR TIPS CREATION - SHORTTERMAND MIDTERM RESULTS IN 20 CONSECUTIVE PATIENTS

Purpose: To assess the suitability of tantalum Strecker stents for tra nsjugular intrahepatic portosystemic shunt (TIPS) creation. Methods: T IPS was performed with Strecker balloon-expandable stents in the first 20 patients of our series. A total of 26 prostheses were utilized (av erage 1.3 per patient). Results: Immediate technical success was achie ved in all 20 cases, Nine patients (45%) died during follow-up. The ov erall average follow-up period was 18.9 months; the 11 survivors were followed for a mean period of 29.8 months, In 4 patients (20%) the ste nt dislodged towards the hepatic vein during withdrawal of the balloon catheter, and difficulties in recatheterizing the shunt for routine c ontrol portal phlebography were frequently encountered, Rebleeding occ urred in 5 cases and aggravation of pre-existing encephalopathy occurr ed in 2 cases. Shunt occlusions or stenosis required further intervent ion in 4 and 9 patients, respectively. Conclusion: In our opinion the tantalum Strecker stent is not particularly suitable for TIPS. Althoug h it has evident advantages, such as high radiopacity and minimal shor tening after deployment, the tendency of the device to dislodge and th e difficulty in recatheterization during portal phlebography were impo rtant drawbacks. Furthermore, the atraumatic ends of the device did no t seem to reduce shunt-related complications, which were comparable to those occurring with other types of stent.