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Efficacy and safety of transjugular intrahepatic portosystemic shunt combined with transcatheter embolization/chemoembolization in hepatocellular carcinoma with portal hypertension and arterioportal shunt

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Objectives

This study seeks to assess the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) combined with transarterial embolization/transarterial chemoembolization (TAE/TACE) in hepatocellular carcinoma (HCC) with portal hypertension and arterioportal shunt (APS).

Methods

Consecutive hospitalized patients having HCC accompanied by portal hypertension and APS were retrospectively analyzed. A total of 103 patients were enrolled. Of them, 26 patients were in Group A and 77 patients were in Group B according to the treatment protocol (Group A: TIPS plus TAE/TACE; Group B: TAE/TACE alone). The clinical outcomes and survival rate were compared between the two groups.

Results

The mean survival time in Group A and Group B were 14 mo and 9.9 mo, respectively, with statistical difference (p = 0.043). The immediate APS improvement rate was 95.2% in Group A and 91.9% in Group B, respectively, with no signficant difference (p = 1.000). However, the first follow-up consultation revealed that APS improvement rate in Group A was more obvious (66.7% vs 27.4%, p = 0.001). Objective response rate of HCC tended to be greater in Group A compared with Group B (65.4% vs 38.7%, p = 0.019). Liver function parameters significantly increased in Group A than those in Group B. After TIPS placement, the mean portal pressure gradient decreased from 32.61 ± 8.87 mmHg to 15.61 ± 8.15 mmHg, with significant difference (p = 0.000). The rate of absorption of ascites and control of variceal bleeding were statistically different between the two groups (p = 0.045 and 0.039, respectively).

Conclusion

Our research suggests that TIPS combined with TAE/TACE seems to be safe and efficacious in patients with HCC accompanied by portal hypertension and APS, albeit may be accompanied by liver function damage.

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Acknowledgements

We thank Dr. Yao-chang Luo, from the First Affiliated Hospital of Guangxi University of Chinese Medicine, for his assistance in performing the TIPS procedure.

Funding

This work was supported by the National Natural Science Foundation of China (Grant No. 81960091) and the Middle-aged and Young Teachers’ Basic Ability Promotion Project of Guangxi Universities (CN) (Grant Number: 2020KY03014).

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Authors and Affiliations

  1. Department of Vascular Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China

    Hai-lin Lu & Xiao Qin

  2. Guangxi Medical University, Nanning, 530021, China

    Fei-fei Xuan

  3. Department of Interventional Radiology, The first Affiliate Hospital of Guangxi University of Chinese Medicine, Nanning, 530023, China

    Yao-chang Luo

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  1. Hai-lin Lu
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Correspondence to Xiao Qin.

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Lu, Hl., Xuan, Ff., Luo, Yc. et al. Efficacy and safety of transjugular intrahepatic portosystemic shunt combined with transcatheter embolization/chemoembolization in hepatocellular carcinoma with portal hypertension and arterioportal shunt. Abdom Radiol 46, 5417–5427 (2021). https://doi.org/10.1007/s00261-021-03214-5

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