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DOI:10.2214/AJR.07.3534
AJR 2008; 191:1751-1757
© American Roentgen Ray Society

Review

Causes of TIPS Dysfunction

Marco Cura1, Alejandro Cura2, Rajeev Suri1, Fadi El-Merhi1, Jorge Lopera1 and Ghazwan Kroma1

1 Cardiovascular and Special Interventions, Department of Radiology, The University of Texas Health Science Center, Mail Code 7800, 7703 Floyd Curl Dr,, San Antonio, TX 78229-3900.
2 Department of Radiology, Hospital de Clinicas, Jose de San Martin, University of Buenos Aires, Buenos Aires, Argentina.

OBJECTIVE. Transjugular intrahepatic portosystemic shunt (TIPS) creation is an effective method to control portal hypertension. TIPS creations with bare stents have shown limited and unpredictable patency. In nearly all cases of rebleeding or recurrent ascites after TIPS creation, there is shunt stenosis or occlusion. The purpose of this article is to review the biologic and technical factors that predispose to TIPS failure and how the use of an expandable polytetrafluoroethylene (PTFE)-covered-stent has significantly improved TIPS patency.

CONCLUSION. Biologic and technical factors may predispose to shunt failure. The combination of improved technique and expandable PTFE has significantly improved TIPS patency. The need for follow-up venography and secondary interventions has been reduced significantly as a result of improved shunt patency.

Keywords: covered stent • interventional radiology • portal hypertension • transjugular intrahepatic portosystemic shunt


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