Background: The clinical outcome of a covered vs. uncovered transjugular intrahepatic portosystemic shunt (TIPS) for patients with Budd-Chiari syndrome (BCS) is as yet largely unknown. Objectives: To compare patency rates of bare and polytetrafluoroethylene (PTFE)-covered stents, and to investigate clinical outcome using four prognostic indices [Child-Pugh score, Rotterdam BCS index, modified Clichy score and Model for End-Stage Liver Disease (MELD)]. Methods: Consecutive patients with BCS who had undergone TIPS between January 1994 and March 2006 were evaluated in a retrospective review in a single centre. Results: Twenty-three TIPS procedures were performed on 16 patients. The primary patency rate at 2 years was 12% using bare and 56% using covered stents (P = 0.09). We found marked clinical improvement at 3 months post-TIPS as determined by a drop in median Child-Pugh score (10-7, P = 0.04), Rotterdam BCS index (1.90-0.83, P = 0.02) and modified Clichy score (7.77-2.94, P = 0.003), but not in MELD (18.91-17.42, P =0.9). Survival at 1 and 3 years post-TIPS was 80% (95% CI: 59-100%) and 72% (95% CI: 48-96%). Four patients (25%) died and one required liver transplantation. Conclusions: A transjugular intrahepatic portosystemic shunt using PTFE-covered stents shows better patency rates than bare stents in BCS. Moreover, TIPS leads to an improvement in important prognostic indicators for the survival of patients with BCS. © 2008 The Authors. Journal compilation

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Keywords Budd-Chiari syndrome, Hepatic vein thrombosis, Portal hypertension, Stents, Transjugular intrahepatic portosystemic shunt
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Journal Liver International
Darwish Murad, S, Luong, T.K, Pattynama, P.M.T, Hansen, B.E, van Buuren, H.R, & Janssen, H.L.A. (2008). Long-term outcome of a covered vs. uncovered transjugular intrahepatic portosystemic shunt in Budd-Chiari syndrome. Liver International, 28(2), 249–256. doi:10.1111/j.1478-3231.2007.01649.x