Causes of TIPS dysfunction.
OBJECTIVE
Transjugular intrahepatic portosystemic shunt (TIPS) creation is an effective method to control portal hypertension. TIPS creations with bare stents have shown limited and unpredictable patency. In nearly all cases of rebleeding or recurrent ascites after TIPS creation, there is shunt stenosis or occlusion. The purpose of this article is to review the biologic and technical factors that predispose to TIPS failure and how the use of an expandable polytetrafluoroethylene (PTFE)-covered-stent has significantly improved TIPS patency.


CONCLUSIONS
Biologic and technical factors may predispose to shunt failure. The combination of improved technique and expandable PTFE has significantly improved TIPS patency. The need for follow-up venography and secondary interventions has been reduced significantly as a result of improved shunt patency.
Cura
Marco
M
Cardiovascular and Special Interventions, Department of Radiology, The University of Texas Health Science Center, Mail Code 7800, 7703 Floyd Curl Dr, San Antonio, TX 78229-3900, USA. curam@uthscsa.edu
Cura
Alejandro
A
Suri
Rajeev
R
El-Merhi
Fadi
F
Lopera
Jorge
J
Kroma
Ghazwan
G
D000328:Adult; D001201:Ascites / Q000175:diagnosis / Q000209:etiology*; D001652:Bile Ducts / Q000293:injuries*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006504:Hepatic Veno-Occlusive Disease / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects*; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000209:etiology*