Shunt dysfunction patterns after transjugular intrahepatic portosystemic shunt creation using a combination of a generic stent-graft and bare-stents

Purpose Even though transjugular intrahepatic portosystemic shunt (TIPS) using Fluency Stent-grafts provides good shunt patency rates, shunt dysfunction is a great concern after TIPS creation, occurring in up to 20% of cases within one year. The objective of this study was to describe shunt dysfunct...

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Bibliographic Details
Published in:CVIR endovascular 2024-01, Vol.7 (1), p.7-7, Article 7
Main Authors: Gravel, Guillaume, Artru, Florent, Gonzalez-Quevedo, Miriam, Tsoumakidou, Georgia, Villard, Nicolas, Duran, Rafael, Denys, Alban
Format: Article
Language:English
Subjects:
Angiography
Imaging
Interventional Radiology
Life Sciences
Medicine
Medicine & Public Health
Original
Original Article
Radiology
Stenosis
Stents
TIPS or Stent Dysfunction
Transjugular intrahepatic portosystemic shunt
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Summary:Purpose Even though transjugular intrahepatic portosystemic shunt (TIPS) using Fluency Stent-grafts provides good shunt patency rates, shunt dysfunction is a great concern after TIPS creation, occurring in up to 20% of cases within one year. The objective of this study was to describe shunt dysfunction patterns after TIPS creation using a combination of generic stent-grafts/bare-stents. Materials and methods Single-center retrospective study of all TIPS revisions between January 2005 and December 2020. TIPS revision angiograms were analyzed for stents’ positions, stenoses’ diameters, and stenoses’ locations. Results Out of 99 TIPS, a total of 33 TIPS revisions were included. The median time to TIPS revision was 10.4 months. Angiograms showed four patterns of TIPS dysfunction-associated features (DAF), defined as follows: Type 1 was defined as stenosis located after the stent end in the hepatic vein (HV), type 2 as intra-stent stenosis located in the hepatic vein, type 3 as intra-stent stenosis or a kink in the parenchymal tract or the portal vein end of the TIPS, and type 4 as a complete TIPS occlusion. Types 1, 2, 3, and 4 were seen in 23 (69.7%), 5 (15.2%), 2 (6.1%), and 3 (9.1%) TIPS respectively. TIPS revision was successful in 30 (90.1%) patients with median pre- and post-TIPS revision PSG of 18.5 mmHg and 8 mmHg respectively ( p  
ISSN:2520-8934
2520-8934
DOI:10.1186/s42155-023-00421-7