Zhang JB, Chen J, Zhou J, Wang XM, Chen S, Chu JG, Liu P, Ye ZD. Systematic review and meta-analysis of trans-jugular intrahepatic portosystemic shunt for cirrhotic patients with portal vein thrombosis. World J Clin Cases 2021; 9(19): 5179-5190 [PMID: 34307565 DOI: 10.12998/wjcc.v9.i19.5179]
Corresponding Author of This Article
Zhi-Dong Ye, MD, Chief Doctor, Department of Cardiovascular Surgery, China-Japan Friendship Hospital, No. 2 Yinghua East Street, Beijing 100029, China. yezhidong6618@yeah.net
Research Domain of This Article
Hematology
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 6, 2021; 9(19): 5179-5190 Published online Jul 6, 2021. doi: 10.12998/wjcc.v9.i19.5179
Systematic review and meta-analysis of trans-jugular intrahepatic portosystemic shunt for cirrhotic patients with portal vein thrombosis
Jian-Bin Zhang, Jie Chen, Jin Zhou, Xu-Ming Wang, Shu Chen, Jian-Guo Chu, Peng Liu, Zhi-Dong Ye
Jian-Bin Zhang, Jie Chen, Jin Zhou, Xu-Ming Wang, Peng Liu, Zhi-Dong Ye, Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing 100029, China
Shu Chen, Department of Interventional Radiology, Affiliated People’s Hospital of Inner Mongolia Medical University, Hohhot 010020, Inner Mongolia Autonomous Region, China
Jian-Guo Chu, Department of Radiology, Air Force Medical Center of PLA, Beijing 100142, China
Author contributions: Zhang JB, Chen J, and Zhou J contributed equally to this work; Zhang JB, Chen J, Zhou J, and Ye ZD designed the research study; Zhang JB, Chen J, Zhou J, Wang XM, and Chen S performed the research; Chu JG and Liu P contributed new reagents and analytic tools; Zhang JB, Chen J, Zhou J, and Chen S analyzed the data and wrote the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors have no conflicts of interests or financial disclosures relevant to this manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Dong Ye, MD, Chief Doctor, Department of Cardiovascular Surgery, China-Japan Friendship Hospital, No. 2 Yinghua East Street, Beijing 100029, China. yezhidong6618@yeah.net
Received: February 13, 2021 Peer-review started: February 13, 2021 First decision: March 14, 2021 Revised: March 21, 2021 Accepted: April 25, 2021 Article in press: April 25, 2021 Published online: July 6, 2021 Processing time: 130 Days and 15.9 Hours
Abstract
BACKGROUND
Portal vein thrombosis (PVT) was previously a contraindication for trans-jugular intrahepatic portosystemic shunt (TIPS).
AIM
To perform a systematic review and meta-analysis of the current available studies investigating outcomes of TIPS for cirrhotic patient with PVT.
METHODS
Multiple databases were systematically searched to identify studies investigating the outcomes of TIPS for cirrhotic patients with PVT. The quality of studies was assessed by Cochrane Collaboration method and Methodological Index for Non-Randomized Studies. The demographic data, outcomes, combined treatment, and anticoagulation strategy were extracted.
RESULTS
Twelve studies were identified with 460 patients enrolled in the analysis. The technical success rate was 98.9% in patients without portal vein cavernous transformation and 92.3% in patients with portal vein cavernous transformation. One-year portal vein recanalization rate was 77.7%, and TIPS patency rate was 84.2%. The cumulative encephalopathy rate was 16.4%. One-year overall survival was 87.4%.
CONCLUSION
TIPS is indicated for portal hypertension related complications and the restoration of pre-transplantation portal vein patency in cirrhotic patients with PVT. Cavernous transformation is an indicator for technical failure. Post-TIPS anticoagulation seems not mandatory. Simultaneous TIPS and percutaneous mechanical thrombectomy device could achieve accelerated portal vein recanalization and decreased thrombolysis-associated complications, but further investigation is still needed.
Core Tip: Trans-jugular intrahepatic portosystemic shunt (TIPS) is indicated for portal hypertension related complications and the restoration of pre-transplantation portal vein patency in cirrhotic patients with portal vein thrombosis. Cavernous transformation is an indicator for technical failure. Post-TIPS anticoagulation seems not mandatory. Simultaneous TIPS and percutaneous mechanical thrombectomy device could achieve accelerated portal vein recanalization and decreased thrombolysis-associated complications, but further investigation is still needed.
