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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 10
Oct.  2016
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Article Contents

Influence of covered stent versus bare stent on long-term efficacy of transjugular intrahepatic portosystemic shunt: a Meta-analysis

DOI: 10.3969/j.issn.1001-5256.2016.10.015
  • Published Date: 2016-10-20
  • Objective To investigate the long-term postoperative efficacy of transjugular intrahepatic portosystemic shunt( TIPS) using polytetrafluoroethylene( PTFE)-covered stent or bare stent,and to provide a basis of evidence-based medicine for the selection of stent in TIPS. Methods CBM,Wanfang Data,CNKI,VIP,MEDLINE,and Pub Med were searched for controlled trials on TIPS in the treatment of cirrhotic portal hypertension published form 1989 to 2015; the studies which met the inclusion criteria were selected,and quality assessment was performed for these articles. Rev Man 5. 3 software was used to analyze the incidence rates of stent dysfunction and hepatic encephalopathy and 1-year survival rate after TIPS,and funnel plots were used to analyze publication bias. Results A total of 11 studies were included,consisting of 698 patients in PTFE-covered stent group and 1283 patients in bare stent group. The results of the meta-analysis showed that the PTFE-covered stent group showed a significantly lower incidence rate of stent dysfunction than the bare stent group( 14. 8% vs 47. 0%,OR = 0. 18,95% CI: 0. 13-0. 24,P < 0. 001). There was no significant difference in the incidence rate of hepatic encephalopathy between the two groups( 23. 5% vs 25. 7%,OR = 0. 88,95% CI: 0. 66-1. 17,P = 0. 37). The PTFE-covered stent group had a significantly higher 1-year survival rate than the bare stent group( 76. 9% vs 62. 7%,OR = 2. 10,95% CI: 1. 54-2. 85,P< 0. 001). The funnel plots which were plotted based on the incidence rates of stent dysfunction and hepatic encephalopathy and 1-year survival rate lacked symmetry,which suggested that a certain degree of publication bias might exist. Conclusion Compared with the bare stent,the PTFE-covered stent can improve stent dysfunction and 1-year survival rate after TIPS,while there is no significant change in the incidence rate of hepatic encephalopathy. Therefore,the PTFE-covered stent has certain advantages over the bare stent in TIPS. In future,multicenter prospective randomized controlled clinical trials with a larger sample size are needed to provide a basis of evidence-based medicine for the application of covered stent in TIPS.

     

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