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Semin intervent Radiol 2023; 40(01): 021-026
DOI: 10.1055/s-0043-1764285
Review Article

Smaller Diameter and Adjustable Diameter Transjugular Intrahepatic Portosystemic Shunts

Aakash N. Gupta
1   Division of Interventional Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, California
,
Daniel Y. Sze
1   Division of Interventional Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, California
,
Diamanto Amanda Rigas
1   Division of Interventional Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, California
2   Division of Interventional Radiology, Department of Radiology, Veteran Administration Palo Alto Health Care System, Palo Alto, California
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Abstract

Complications of overshunting, including hepatic encephalopathy and hepatic insufficiency, remain prevalent following transjugular intrahepatic portosystemic shunt (TIPS) creation. Smaller diameter TIPS may reduce the risk of overshunting, but the use of smaller stents must be weighed against the risk of undershunting and persistent or recurrent hemorrhage, ascites, and other complications of portal hypertension. This article explores the question of optimal shunt diameter by examining outcomes for smaller diameter TIPS stent-grafts (<10 mm), underdilated stent-grafts, and variable diameter stent-grafts.

Keywords

TIPS - small diameter - controlled expansion - interventional radiology - portal hypertension


Publication History

Article published online:
04 May 2023

© 2023. Thieme. All rights reserved.

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