Related Factors of Distal Portal Vein Thrombosis and its Effect on Prognosis in Patients with Cirrhotic Portal Hypertension after TIPS
Objective:To explore the influencing factors of distal portal vein thrombosis and its effect on prognosis in patients with cirrhotic portal hypertension after transjugular intrahepatic portosystemic shunt(TIPS).Methods:300 patients with cirrhotic portal hypertension who underwent TIPS in Nanfang Hospital of Southern Medical University from January 2021 to January 2023 were selected,patients were divided into thrombosis group and non-thrombosis group according to the occurrence of distal thrombosis of portal vein branches within 6 months after operation.Compared the clinical data of two groups,the related factors of distal portal vein thrombosis after TIPS were analyzed by Multivariate Logistic regression.The prognosis in two groups at 6 months after operation was compared.Results:The incidence of distal portal vein thrombosis was 10.67％(32/300)after operation.There were statistically significant differences in the proportion of age,plasma D-dimer(D-D),total cholesterol(TC),low density lipoprotein(LDL)levels within 3 days before operation,main portal vein diameter,left portal vein diameter,Child-Pugh grade A ratio,portal vein flow rate between thrombosis group and non-thrombosis group(P＜0.05).Multivariate Logistic regression analysis showed that advanced age,elevated LDL levels,and increased diameter of the left portal vein diameter were risk factors for distal portal vein thrombosis after TIPS,while Child Pugh grade A was protective factor(P＜0.05).There was no significant difference in TIPS stent patency rate,hepatic encephalopathy,liver function injury and mortality rate between thrombosis group and non-thrombosis group at 6 months after TIPS(P＞0.05).Conclusions:The distal portal vein thrombosis after TIPS in cirrhotic portal hypertension is related to age,preoperative LDL,Child-Pugh classification and diameter of left portal vein,but has no effect on the 6-month postoperative TIPS stent patency rate,hepatic encephalopathy,liver function injury,and mortality rate in patients.
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