Primary placement of Palmaz long medium stents in transjugular intrahepatic portosystemic shunts

PURPOSE: To describe our results with primary placement of the long-medium Palmaz stent for transjugular intrahepatic portosystemic shunts (TIPS), MATERIALS AND METHODS: Between December 1997 and December 1998 primary plac ement of long-medium Palmaz stents was performed for TIPS procedures in 17 patients. Patency was determined with ultrasound, angiography, or pathologi c examination in the event of transplant. RESULTS: Primary patency was achieved in 13 of 17 patients (76.5%) (follow up, 1-399 days; mean, 99 days). Secondary patency was achieved in 17 of 17 patients (100%) (follow-up, 1-399 days; mean, 110 days). Among the four pat ients who required revision, the mean time to revision from initial shunt c reation was 81 days (range, 13-125 days). Two of these four patients had sy mptoms of worsening ascites as well as abnormal ultrasound findings prior t o their revision; the other two patients were asymptomatic and had abnormal ultrasound findings only. Revisions were performed for intimal hyperplasia within the stent in three of the patients and acute thrombus within the st ent in the remaining patient. Kaplan-Meier survival analysis for primary pa tency yielded mean survival time of 265 days (standard error, 52 days). CONCLUSION: The long-medium Palmaz stent is a viable stent for creation of TIPS shunts.