Should transjugular intrahepatic portosystemic shunt stent grafts be underdilated?

Journal of Vascular and Interventional Radiology : JVIR
Ron C GabaJames T Bui

Abstract

Although underdilation of transjugular intrahepatic portosystemic shunt (TIPS) stent grafts is commonly performed to limit complications arising from excessive portosystemic shunting, it is uncertain whether underdilated stents retain their smaller diameter indefinitely or eventually expand to nominal caliber. In this investigation, postprocedure computed tomography (CT) was used to compare diameters of underdilated TIPSs and TIPSs expanded to a nominal diameter of 10 mm in 61 cases. The groups had comparable shunt diameters on post-TIPS imaging (9.8 mm vs 9.9 mm; P = .079), with similar incidences of hepatic encephalopathy (34% vs 20%; P = .372), indicating stent self-expansion over time, and bringing into question the advantages of underdilation for customization of shunt caliber.

References

Jan 22, 2005·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Thomas D BoyerUNKNOWN American Association for the Study of Liver Diseases
Dec 23, 2008·Journal of Vascular and Interventional Radiology : JVIR·Hyun S JungStephan T Wicky
Dec 20, 2011·Journal of Vascular and Interventional Radiology : JVIR·Ron C GabaCharles A Owens
Mar 5, 2013·Scandinavian Journal of Gastroenterology·Muna PalikheMeng Zhang

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Citations

Mar 22, 2016·Techniques in Vascular and Interventional Radiology·Ron C Gaba
Mar 5, 2015·Journal of Vascular and Interventional Radiology : JVIR·Ziv J Haskal
Mar 8, 2017·European Journal of Radiology·Ashkan MollaiyanMartin Rössle
Aug 24, 2018·Alimentary Pharmacology & Therapeutics·Rosalie C OeyHenk R van Buuren
Jun 19, 2021·Clinical and Translational Gastroenterology·Jiacheng LiuBin Xiong

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