13th Annual Global Embolization Symposium & Technologies
Purpose : Transjugular intrahepatic portosystemic shunt (TIPS) with adjunctive embolotherapy has recently been reported as an effective and safe approach for variceal bleeding for patients with cirrhosis. Nevertheless, few research focuses on embolic agents for embolotherapy. The purpose of this study was to compare treatment efficacy, safety and cost between tissue gel and coil regarding variceal embolization during TIPS.
Material and Methods : This retrospective study included cirrhotic patients with variceal bleeding treated with TIPS combined with variceal embolization between January, 2016 and August, 2017. Patients were divided into three groups according to embolic agents used in variceal embolization: tissue gel group (Group A), combination group (Group B), and coil group (Group C).The primary endpoint was 1-year rebleeding rate after TIPS creation. The secondary endpoints included shunt dysfunction, overt hepatic encephalopathy, liver function, total fluoroscopy and procedure time, and embolic agents-related expense.
Results : A total of 60 patients (30, 10, and 20 in Group A, B, and C) were included. Variceal rebleeding occurred in 3 (10%), 0 (0%), and 4 (20%) patients within one year after TIPS creation in Group A, B, and C, respectively. Stent dysfunction occurred in 2 (3.3%) patients and 9 (15.0%) patients experienced overt hepatic encephalopathy. No significant differences were observed between three groups regarding primary and secondary endpoints except embolic agents-related expense, with a significantly lower cost in Group A when compared to the other two groups.
Conclusions : Tissue gel has similar treatment efficacy and safety on variceal embolization with significantly lower cost when compares to coil or tissue gel combines with coil for variceal embolization during TIPS.