Should transjugular intrahepatic portosystemic shunt stent grafts be underdilated?
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.
Department of Radiology and Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, 1740 W. Taylor St., MC 931, Chicago IL 60612. Electronic address: rgaba@uic.edu.
Ron C
RC
Gaba
University of Illinois College of Medicine, University of Illinois Hospital and Health Sciences System, 1740 W. Taylor St., MC 931, Chicago IL 60612.
Ahmad
A
Parvinian
Department of Radiology and Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, 1740 W. Taylor St., MC 931, Chicago IL 60612.
Jeet
J
Minocha
University of Illinois College of Medicine, University of Illinois Hospital and Health Sciences System, 1740 W. Taylor St., MC 931, Chicago IL 60612.
Leigh C
LC
Casadaban
Department of Radiology and Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, 1740 W. Taylor St., MC 931, Chicago IL 60612.
M Grace
MG
Knuttinen
Department of Radiology and Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, 1740 W. Taylor St., MC 931, Chicago IL 60612.
Charles E
CE
Ray
Department of Radiology and Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, 1740 W. Taylor St., MC 931, Chicago IL 60612.
James T
JT
Bui
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004106:Dilatation / Q000295:instrumentation* / Q000379:methods; D019544:Equipment Failure Analysis; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000295:instrumentation* / Q000379:methods*; D011474:Prosthesis Design; D017755:Prosthesis Fitting / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome