Selection of a TIPS stent for management of portal hypertension in liver cirrhosis: An evidence-based review

Table 3 Comparison of outcome after transjugular intrahepatic portosystemic shunt between covered and bare stents: An overview of comparative studies

Ref.	Period	Target population	No. patients (covered/bare)	Efficacy of TIPS (covered/bare)	Shunt dysfunction or patency (covered/bare)	Post-TIPS encephalopathy (covered/bare)	Survival or death (covered/bare)
Luca et al[45]	2003.1-2010.2	Cirrhotic patients with non-tumoural PVT	70 (57/13)	NA	12-mo shunt dysfunction rate: 21%/38%; 24-mo shunt dysfunction rate: 29%/85%	NA	NA
Sommer et al[58]	2001.2-2011.1	Patients with elective TIPS procedures	174 (58/116)	Clinical success rate: ascites: 90.5%/81.3%; ascites + bleeding: 85.7%/73.7%; bleeding: 90.0%/86.2% (NS)	12-mo primary shunt patency rate: 62.4%/43.9% (P < 0.05)	Overall rate: 36.5%/37.5% (NS)	12-mo survival rate: 79.1%/75.6%; overall survival time: 835.25 ± 823.0 (9–3200)/805.6 ± 868.4 (6–3290) d (NS)
Clark et al[59]	2001-2010	Patients with PH	246 (176/70)	NA	Overall shunt dysfunction rate: 22%/ 57% (P = 0.05)	NA	Survival time: 33/31 mo (P = 0.5)
Maleux et al[60]	1992-2006	Cirrhotic patients with refractory ascites	222 (126/96)	Rate of clinically significant residual ascites 1 mo after TIPS: 35.5%/55.6% (P = 0.003)	1-yr shunt dysfunction rate: 19%/49% (P < 0.0001)	1-yr rate: 22%/56% (P < 0.0001)	6-mo survival rate: 73.2%/62.8%; 1-yr survival rate: 65.5%/55.0% (P = 0.0071)
Wu et al[61]	2007.4-2009.4	Patients with PH	60 (30/30)	Number of rebleeding: 1/6 (P = 0.04)	Number of shunt dysfunction: 0/9 (P = 0.002)	Number: 5/6 (P = 0.74)	Number of death: 0/4 (P = 0.038)
Bandi et al[62]	2006.3-2009.3	Patients with PH	66 (33/33)	Clinical relapse number (rate): 8 (26%)/15 (45%) (P < 0.05)	Number of shunt dysfunction: 5/15 (P < 0.05)	Overall rate: 22%/33% (NS)	Overall survival rate: 66%/37% (P < 0.05)
Jung et al[63]	1996.6-2006.2	Patients who received de novo TIPS	81 (51/30)	Bleeding group: 3-mo clinical success rate: 100%/58% (P = 0.03); 12-mo clinical success rate: 67%/18% (P = 0.046). Ascites group: 3-mo clinical success rate: 77%/70% (P = 0.2); 12-mo clinical success rate: 64%/33% (P = 0.18)	3-mo primary patency rate: 94%/63% (P = 0.03); 6-mo primary patency rate: 67%/ 8% (P = 0.47); 12-mo primary patency rate: 38%/24% (P = 0.65)	Overall rate: 15%/14% (P = 0.7)	Bleeding group: 30-d mortality rate: 40%/33% (P = 0.69); overall mortality rate: 40%/50% (P = 0.57). Ascites group: 30-d mortality rate: 6%/27% (P = 0.13); overall mortality rate: 13%/55% (P = 0.02)
Pan et al[64]	2001.1- 2005.12	Patients with variceal bleeding and refractory ascites	128 (57/71)	NA	30-d shunt dysfunction rate: 1.8%/4.2% (P = 0.4); 6-mo shunt dysfunction rate: 5.2/25.3% (P = 0.003); 1-yr shunt dysfunction rate: 5.2%/30.9% (P = 0.004); overall shunt dysfunction rate: 8.7%/40.8% (P = 0.004)	NA	6-mo mortality rate: 10.5%/16.9% (P = 0.3); 1-yr mortality rate: 14%/23.9% (P = 0.2); overall mortality rate: 21.1%/35.2% (P = 0.08)
Tripathi et al[65]	1991.7- 2004.12	Patients with variceal bleeding, ascites, portal hypertensive gastropathy, hepatic hydrothorax	473 (157/316)	2-yr cumulative rebleeding rate: 6%/17% (P < 0.05)	2-yr cumulative shunt dysfunction rate: 11%/74% (P < 0.001); overall shunt dysfunction rate: 8%/48%	2-yr cumulative rate: 23%/38% (P < 0.05)	2-yr cumulative mortality rate: 49%/50%
Gandini et al[66]	1994.1- 2003.11	Patients with BCS	13 (7/6)	Clinical relapse rate: 100%/0%	6-mo primary patency rate: 100%/16.7%; 12-mo primary patency rate: 85.7%/0% (P < 0.001, Log-Rank)	Overall rate: 0%/0%	NA
Barrio et al[67]	1998.9-2002.5	Cirrhotic patients with PH related complications	70 (20/50)	Rate of clinical recurrence of portal hypertension related complications: 0%/22% (P = 0.085)	6-mo shunt dysfunction rate: 0%/32%; 12-mo shunt dysfunction rate: 0%/82% (P = 0.03, Log-Rank)	1-mo rate: 41%/20%; 3-mo rate: 44%/34%; 9-mo rate: 44%/40% (P = 0.5, Log-Rank)	6-mo survival rate: 67%/88%; 12-mo survival rate: 67%/81% (P = 0.11, Log-Rank)
Bureau et al[68,69]	2000.2-2002.4	Patients with cirrhosis and uncontrolled bleeding, recurrent bleeding, or refractory ascites	80 (39/41)	Clinical relapse rate: 7.7%/29.3%	1-yr primary patency rate: 85.6%/46.6%; 2-yr primary patency rate: 80.2%/18.6% (P = 0.0005, Log-Rank)	1-yr rate: 22%/41% (P = 0.0586)	1-yr survival rate: 70.9%/59.5%; 2-yr survival rate: 64.5%/40.5%

BCS: Budd-Chiari syndrome; NA: Not available; NS: Not significant; PH: Portal hypertension; PVT: Portal vein thrombosis; TIPS: Transjugular intrahepatic portosystemic shunt.