TIPS reduction with use of stents or stent-grafts.
This report describes new techniques to perform TIPS reduction in patients with post-TIPS complications. Methods included hourglass-shaped stents and stent-grafts, and parallel stents and stent-grafts. All procedures were technically successful, resulting in increased portosystemic gradients and decreased symptoms, although patient outcomes were mixed. None of the patients experienced recurrent variceal hemorrhage or ascites in short-term follow-up. Stent-grafts have the advantage of immediate exclusion of blood flow outside the reducing stent, resulting in an immediate reduction of the caliber of the shunt. Techniques that allow fine adjustment of shunt diameters may have further advantages.
Saket
Ramin R
RR
Division of Cardiovascular and Interventional Radiology, Stanford University Medical Center, Stanford, California 94305-5642, USA.
Sze
Daniel Y
DY
Razavi
Mahmood K
MK
Kee
Stephen T W
ST
Frisoli
Joan K
JK
Semba
Charles P
CP
Dake
Michael D
MD
D000368:Aged; D001201:Ascites / Q000601:surgery*; D004932:Esophageal and Gastric Varices / Q000601:surgery*; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011183:Postoperative Complications / Q000628:therapy*; D015607:Stents; D016896:Treatment Outcome