Ces radiol. 2018, 72(4):254-257 | DOI: 10.55095/CesRadiol2018/034

TIPS in the Czech Republic: current practiceOriginal article

Pavla Čabelková¹, Jozef Kováč², Jan H. Peregrin², Libor Kindl³, Martin Köcher⁴, Jakub Hustý⁵, Radim Pavlík⁶, Antonín Krajina¹

¹ LF UK a FN, Hradec Králové

² IKEM, Praha

³ Nemocnice Most

⁴ LF PU a FN, Olomouc

⁵ LF MN a FN, Brno

⁶ LF UK a FN Motol, Praha

Aim: Purpose of this study was to assess current practice in the Transjugular Intrahepatic Portosystemic Shunts (TIPS) creation in the Czech Republic.

Methods: Questionnaire was sent to all university hospitals and regional hospitals. Numbers of procedures were requested in the last three years (2015-2017). There was also question about indications for TIPS during the last year and availability of urgent TIPS. We monitored 30day mortality and number of TIPS revisions in the last year (2017). Proportion of dedicated stentgrafts versus bare stents used was evaluated as well.

Results: All hospitals answered. TIPS is being performed in 6 centres. There were performed 70 procedures in 2015, 87 procedures in 2016, and 96 in 2017. All centres declared availability for urgent TIPS creation. There were 57% procedures done for ascites (including patients with Budd-Chiari syndrome) and 43% for bleeding (including patients with portal vein thrombosis) in 2017. There were 3 centres where TIPS was indicated also for other indications beside bleeding or refractory ascites (8% of patients). These indications were portal vein thrombosis, Budd Chiari syndrome, and TIPS creation in a pediatric patient. The TIPS revisions were performed by all centres. Reported thirty day mortality was in range from 10 to 33%. TIPS dedicated stentgrafts were commonly implanted in all centres and in two of these centres also selfexpandable bare stents were used in 59% and 19% of cases.

Conclusion: The Czech Republic has homogeneous geographical availibility of centres providing TIPS procedures on urgent basis. Half of these centres provide even technically more difficult procedures for the portal vein or hepatic vein thrombosis, or TIPS in children. Patients are followed after TIPS procedure in all centres.

Keywords: portal hypertension, TIPS, interventional radiology, gastrointestinal bleeding

Accepted: November 15, 2018; Published: December 1, 2018  Show citation