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J Vasc Interv Radiol. 2008 Nov;19(11):1653-8. doi: 10.1016/j.jvir.2008.08.011. Epub 2008 Sep 26.

Bidirectionally adjustable TIPS reduction by parallel stent and stent-graft deployment.

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  • 1Division of Interventional Radiology, Stanford University Medical Center, 300 Pasteur Drive, H-3646, Stanford, CA 94305-5642, USA. dansze@stanford.edu


Excessive shunting through transjugular intrahepatic portosystemic shunts (TIPS) can cause life-threatening hepatic encephalopathy and insufficiency. Intentional reduction of flow may be effective but difficult to control. The present report describes refinements of the parallel stent/stent-graft technique of flow reduction that is adjustable in either direction. Six patients underwent TIPS reduction with varying stent positioning and a variety of commercial products. Flow was adjusted by iterative balloon dilatation of the stent and stent-graft, resulting in a mean gradient increase of 8 mm Hg. All cases were technically successful, but 1-year survival was seen in only the patient who underwent liver transplantation.

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