Title: Overdilation of the Wallstent to optimize portal decompression during transjugular intrahepatic portosystemic shunt placement.
Abstract:To optimize shunt size with overdilation of the Wallstent during creation of a transjugular intrahepatic portosystemic shunt (TIPS).A TIPS was created in 25 patients with variceal bleeding (n = 22) or...To optimize shunt size with overdilation of the Wallstent during creation of a transjugular intrahepatic portosystemic shunt (TIPS).A TIPS was created in 25 patients with variceal bleeding (n = 22) or intractable ascites (n = 3). All shunts were created with one or more Wallstents that were dilated with an 8- or 10-mm balloon. In 11 patients with inadequate portal decompression or persistent filling of varices, shunts were overdilated with a 12-mm balloon.Mean portosystemic pressure gradient fell from 18.0 mm Hg +/- 6.4 (standard deviation) to 6.8 mm Hg +/- 2.8 after shunt placement. In 11 patients in which shunts were overdilated, the mean gradient fell from 12.7 mm Hg +/- 5.6 after 10-mm dilation to 6.9 mm Hg +/- 2.8 (P = .01) after 12-mm dilation. In six, variceal filling occurred after 10-mm dilation but diminished or ceased after overdilation. Stent disruption did not occur. New or worsened encephalopathy occurred in four of 14 patients with 10-mm and six of 11 patients with 12-mm shunt dilation and responded to medical therapy in all but two.Overdilation of the Wallstent during TIPS placement is effective and safe in patients with inadequate portal decompression after 10-mm shunt dilation.Read More
Publication Year: 1994
Publication Date: 1994-04-01
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
Access and Citation
Cited By Count: 12
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