Smaller Diameter and Adjustable Diameter Transjugular Intrahepatic Portosystemic Shunts

Aakash N Gupta; Daniel Y Sze; Diamanto Amanda Rigas

doi:10.1055/s-0043-1764285

Smaller Diameter and Adjustable Diameter Transjugular Intrahepatic Portosystemic Shunts

Semin Intervent Radiol. 2023 May 4;40(1):21-26. doi: 10.1055/s-0043-1764285. eCollection 2023 Feb.

Authors

Aakash N Gupta¹, Daniel Y Sze¹, Diamanto Amanda Rigas^{1

2}

Affiliations

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.

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; controlled expansion; interventional radiology; portal hypertension; small diameter.

Publication types

Review