title: Parallel shunt for the treatment of transjugular intrahepatic portosystemic shunt dysfunction.
abstract: OBJECTIVE
  To investigate the safety, efficacy and long-term patency of parallel shunts (PS) in the management of the transjugular intrahepatic portosystemic shunt (TIPS) dysfunction.
  
  
  METHODS
  Between March 2007 and October 2010, 18 patients (13 men and 5 women) who underwent TIPS revision with the creation of PS were evaluated retrospectively. In the first 10 patients, a 10-mm-diameter Wallgraft endoprosthesis was deployed; in the latter 8 patients, an 8-mm-diameter Fluency endoprosthesis was deployed.
  
  
  RESULTS
  The creation of PS was technically successful in all patients. The mean ± standard deviation portosystemic pressure gradient before and after the procedure was 25.5 ± 7.3 mm Hg (range, 16-37 mm Hg) and 10.9 ± 2.3 mm Hg (range, 7-16 mm Hg), respectively. The duration of follow-up was 16.7 ± 10.8 months (range, 6-42 months). The primary shunt patency rates at 12 months after the creation of PS was 70% with Wallgraft endoprostheses and 87.5% with Fluency endoprostheses.
  
  
  CONCLUSIONS
  TIPS revision with the creation of PS is a safe, effective and durable method for treating shunt dysfunction.
authors.affiliation: Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Luo
authors.forename: Ling
authors.initials: L
authors.lastname: Nie
authors.forename: Jiaywei
authors.initials: J
authors.lastname: Tsauo
authors.forename: Zhu
authors.initials: Z
authors.lastname: Wang
authors.forename: Chengwei
authors.initials: C
authors.lastname: Tang
authors.forename: Xiao
authors.initials: X
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D001795:Blood Pressure Determination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects / Q000379:methods*; D011474:Prosthesis Design; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D015607:Stents
chemical_list: D011138:Polytetrafluoroethylene
keywords: Parallel shunt; Revision; Stent-graft; Transjugular intrahepatic portosystemic shunt