title: Primary creation of an externally constrained TIPS: a technique to control reduction of the portosystemic gradient.
abstract: OBJECTIVE
  Transjugular intrahepatic portosystemic shunt (TIPS) creation increases the risk of hepatic encephalopathy due to overshunting. Techniques exist to secondarily reduce the shunt for refractory encephalopathy. The purpose of this article is to describe a technique for primary TIPS restriction using a balloon-expandable stent within the transvenous hepatic track followed by deployment of a self-expanding polytetrafluoroethylene-lined stent-graft within the balloon-expandable stent to create the TIPS.
  
  
  CONCLUSIONS
  This technique enables control over the degree of portosystemic shunting in elective TIPS creation.
authors: 1 Dotter Interventional Institute, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, L605, Portland, OR 97239.
authors: Khashayar
authors: K
authors: Farsad
authors: Kenneth J
authors: KJ
authors: Kolbeck
authors: Frederick S
authors: FS
authors: Keller
authors: Robert E
authors: RE
authors: Barton
authors: John A
authors: JA
authors: Kaufman
mesh_terms: D000328:Adult; D001201:Ascites / Q000209:etiology / Q000628:therapy*; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000628:therapy*; D006801:Humans; D006876:Hydrothorax / Q000209:etiology / Q000628:therapy*; D008103:Liver Cirrhosis / Q000150:complications / Q000628:therapy* / Q000821:virology; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D015607:Stents
chemical_list: D011138:Polytetrafluoroethylene
keywords: TIPS; TIPS reduction; hepatic encephalopathy; stent-graft; transjugular intrahepatic portosystemic shunt