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Effects of Postinterventional Antithrombotic Use on Transjugular Intrahepatic Portosystemic Shunts: Evaluation of DeGIR Registry Data (Germany, 2021–2024)

Estler A, Vogl TJ, Koehler M, Scheurig-Münkler C, Schmid A, Paprottka P, Nadjiri J, Pitton MB, Brücker A, Theysohn J, Hauptvogel K, Clodi N, Hecke G, Wacker FK, Wildgruber M, Nikolaou K, Grözinger G (2026)

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Publication Type: Journal article

Publication year: 2026

Journal

Article Number: RoeFo-4413-IR-03-2026

DOI: 10.1055/a-2927-1462

Abstract

Purpose Antithrombotic therapy after transjugular intrahepatic portosystemic shunt (TIPS) implantation remains a controversial topic. This study aimed to evaluate clinical outcomes and shunt patency following TIPS placement, with a focus on comparing shunt occlusion rates between patients receiving different commonly used postprocedural antithrombotic regimens. Materials and Methods This prospective registry-based study included 367 patients who underwent primary TIPS implantation and follow-up in Germany between January 20, 2021, and February 18, 2024. Information regarding postprocedural antithrombotic use was available for 304 patients. However, complete 12-month follow-up data regarding shunt patency were available for 96 patients, who were included in the final comparative analysis. Data were extracted from the registry of the German Society of Interventional Radiology (DeGIR). Shunt patency rates between patients with and without postinterventional antithrombotic therapy were compared using the chi-squared test. A p-value < 0.05 was considered statistically significant (95% confidence interval). No adjustment for potential confounding variables was performed. Results Of the 304 patients with available antithrombotic data, 212 (69.74%) received postprocedural antithrombotics, whereas 92 (30.26%) did not. The most frequently administered antithrombotic therapy was low molecular weight heparin (LMWH), used in 44.74% of patients, most commonly for a duration of 7-30 days (34.56% of patients receiving LMWH). Among patients with patent shunts at the 12-month follow-up, 25 patients (92.59%) had received antithrombotics, whereas two patients (7.41%) had not. In contrast, among patients with shunt occlusion, 34 patients (49.28%) had received antithrombotics and 35 patients (50.72%) had not. Postprocedural antithrombotic therapy was significantly associated with improved shunt patency at 12 months (p < 0.001). Conclusion Shunt occlusion remains a relevant complication following TIPS implantation. Although the indication for routine antithrombotic use after TIPS placement remains uncertain, the findings of this study suggest that postprocedural antithrombotic therapy is significantly associated with improved shunt patency within 12 months after implantation. Due to the observational design and lack of confounder adjustment, causal conclusions cannot be drawn. Further prospective controlled studies are warranted.

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APA:

Estler, A., Vogl, T.J., Koehler, M., Scheurig-Münkler, C., Schmid, A., Paprottka, P.,... Grözinger, G. (2026). Effects of Postinterventional Antithrombotic Use on Transjugular Intrahepatic Portosystemic Shunts: Evaluation of DeGIR Registry Data (Germany, 2021–2024). Röfo: Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren. https://doi.org/10.1055/a-2927-1462

MLA:

Estler, Arne, et al. "Effects of Postinterventional Antithrombotic Use on Transjugular Intrahepatic Portosystemic Shunts: Evaluation of DeGIR Registry Data (Germany, 2021–2024)." Röfo: Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren (2026).

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