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Bañares R _et al_. (2005) Patients with cirrhosis and bare-stent TIPS may have increased risk of hepatocellular carcinoma. _Hepatology_ 41: 566–571 Hepatocellular carcinoma (HCC) is a major
cause of death in patients with cirrhosis, but risk factors for its development have not been fully defined. It has been suggested that the TIPS procedure might contribute to development of
HCC because it results in physical effects similar to those resulting from surgical shunting, a procedure that has been associated with HCC in some studies. This retrospective study of two
groups of patients (with and without bare-stent TIPS) assessed the relative risk of HCC development. Patients' records were evaluated if they had at least 6 months of follow-up, with
diagnosis of HCC during the surveillance period being the primary endpoint. Patients in the TIPS cohort were significantly more likely to develop HCC than patients in the non-TIPS cohort
(adjusted hazard ratio 1.52, _P_ = 0.02). This increase in risk was independent of secondary intervention to improve shunt function. Age >57 years and cirrhosis resulting from infection
with hepatitis C virus were independently associated with HCC onset, but these associations were statistically insignificant. The mechanisms underlying the increased risk of HCC development
in the TIPS group were not elucidated in this study. The use of polytetrafluoroethylene-covered stents rather than bare stents might improve outcome, because changes in blood flow after
shunt placement have been associated with hyperplasia, and covered stents might result in better control of portal hypertension. The authors also suggest that patients with TIPS should be
screened more frequently in order to detect HCC development at an earlier stage. CHANGE HISTORY * _ 17 MAY 2018 This article was published with the same DOI as a previous publication. A new
DOI has been assigned and registered at Crossref, and has been corrected in the article. _ GLOSSARY * TIPS Transjugular intrahepatic portosystemic shunt RIGHTS AND PERMISSIONS Reprints and
permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Increased risk of hepatocellular carcinoma with TIPS for cirrhosis?. _Nat Rev Gastroenterol Hepatol_ 2, 207 (2005).
https://doi.org/10.1038/ncponc0160x Download citation * Issue Date: 01 May 2005 * DOI: https://doi.org/10.1038/ncponc0160x SHARE THIS ARTICLE Anyone you share the following link with will be
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