Procalcitonin as a Biomarker for Early Trans-jugular Intrahepatic Porto-Systemic Shunt (TIPS) Stent Occlusion Prediction in Patients with Budd Chiari Syndrome

Abstract

Background and study aim: One of the serious complications infrequently reported with transjugular intrahepatic portosystemic shunt (TIPS) stent endovascular infection is bacteremia in up to 35% of patients. White blood cells (WBCs), procalcitonin (PCT), and C-reactive protein (CRP) could be used with ease for those infections' diagnosis and follow-up. In this study, we sought to investigate the potential biomarkers of infection and early TIPS stent occlusion in BCS patients by looking at the relationship between bacteremia and aberrant serum procalcitonin (PCT) levels before and after TIPS. Patients and Methods: Thirty BCS patients with TIPS participated in this pilot exploratory investigation. For every patient, the following data were collected: procalcitonin (PCT) levels pre-TIPS, two days post-TIPS, two weeks post-TIPS, or at the time of stent occlusion; erythrocyte sedimentation rates (ESRs), blood cultures; and C-reactive protein levels. Results: With a sensitivity of 100% and a specificity of 95.6%, there was a statistically significant increase in PC levels in blood culture-positive patients before and two weeks after TIPS or at the time of stent occlusion. Additionally, in patients with obstructed stents, there was a correlation between positive blood culture results before and two weeks after TIPS. Regardless of the blood culture results, PCT levels were also higher in patients with occluded stents two days and two weeks after TIPS or at the time of stent occlusion. Conclusion: PCT is a valuable infection biomarker and its levels are elevated post-TIPS in Budd Chiari patients with occluded stents.