Transjugular intrahepatic portosystemic shunt flow reduction with adjustable polytetrafluoroethylene-covered balloon-expandable stents.
Creation of a transjugular intrahepatic portosystemic shunt (TIPS) can effectively treat complications of portal hypertension, but excessive shunting can cause life-threatening hepatic encephalopathy and hepatic insufficiency. The present report describes a novel technique that allows for controlled and adjustable flow reduction through the TIPS via partial closure of the shunt with a balloon-mounted covered stent. The method results in clinical improvement of hepatic encephalopathy and hepatic insufficiency and immediate increase in the portosystemic pressure gradient. However, among the four patients described herein, survival beyond 1 year was seen in only one, who underwent liver transplantation after TIPS reduction.
Kroma
Ghazwan
G
Department of Interventional Radiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, Mail Stop 7800, San Antonio, TX 78229-3900, USA. kroma@uthscsa.edu
Lopera
Jorge
J
Cura
Marco
M
Suri
Rajeev
R
El-Merhi
Fadi
F
Reading
Jerad
J
D002404:Catheterization / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible / Q000737:chemistry*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene / Q000737:chemistry*; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000295:instrumentation*; D019919:Prosthesis Implantation / Q000295:instrumentation*; D015607:Stents
D020099:Coated Materials, Biocompatible; D011138:Polytetrafluoroethylene