Diagnostic and Interventional Radiology
Interventional Radiology - Original Article

Combined Y-configured stents for revising occluded transjugular intrahepatic portosystemic shunt

1.

Department of Gastroenterology and Hepatology, Sichuan University-University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer, West China Hospital, Sichuan University, Chengdu, China

2.

Department of Gastroenterology and Hepatology, Second Affiliated Hospital of Chongqing Medical Univeristy, Chongqing, China

Diagn Interv Radiol 2021; 27: 238-243
DOI: 10.5152/dir.2021.20036
Read: 171 Downloads: 72 Published: 18 May 2020

PURPOSE 
We aimed to determine the technical feasibility, safety and prognosis of the transjugular intrahepatic portosystemic shunt (TIPS) revision by combined Y-configured stents placement.

METHODS
We retrospectively evaluated 12 patients who received TIPS revision using Y-stenting technique between June 2015 and January 2019. The rates of technical success, complication, shunt patency, hepatic encephalopathy and mortality were described and analyzed.

RESULTS
The combined Y-configured stents were successfully placed in 11 of 12 patients (92%) without major complications. The median portosystemic pressure gradient (PPG) decreased from 23 mmHg (interquartile range, IQR, 18.5–27.5 mmHg) to 10 mmHg (IQR, 9–14 mmHg). The left internal jugular vein approach was used in 5 patients. Four patients required a shunt extension with an extra stent to resolve the stenosis at the portal venous terminus. Two patients developed hepatic encephalopathy, which was medically controlled within 3 months after the procedure. The TIPS patency and survival rates were both 100% during a median follow-up period of 10 months (IQR, 5.5–14 months).

CONCLUSION
TIPS revision by combined Y-configured stents placement was technically feasible and safe with favorable clinical outcomes.

You may cite this article as: Wang X, Zhu Y, Zhao M, Luo X, Yang L. Combined Y-configured stents for revising occluded transjugular intrahepatic portosystemic shunt. Diagn Interv Radiol 2021; 27: 238–243

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