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  • Title: Combined Y-configured stents for revising occluded transjugular intrahepatic portosystemic shunt.
    Author: Wang X, Zhu Y, Zhu M, Luo X, Yang L.
    Journal: Diagn Interv Radiol; 2021 Mar; 27(2):238-243. PubMed ID: 33517256.
    Abstract:
    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.
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