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Stent-graft narrowed with a lasso catheter: an adjustable TIPS reduction technique
Valérie Monnin-Bares1, Frédéric Thony, Christian Sengel
1Department of Radiology, Chu A. Michallon, Grenoble University 1, La Tronche, BP 217, Grenoble 38043, France. val_monnin@yahoo.fr
Journal of Vascular and Interventional Radiology : JVIR
|February 4, 2010
Summary
This study presents a novel endovascular technique to reduce shunt diameter for managing hepatic encephalopathy after transjugular intrahepatic portosystemic shunt (TIPS) creation. The method successfully improved patient outcomes by adjusting shunt size, offering a new treatment option.
Area of Science:
- Interventional Radiology
- Hepatology
- Vascular Surgery
Background:
- Transjugular intrahepatic portosystemic shunt (TIPS) creation can lead to refractory hepatic encephalopathy.
- Managing refractory hepatic encephalopathy often requires reducing the TIPS shunt diameter.
Purpose of the Study:
- To describe a novel endovascular technique for adjustable reduction of TIPS shunt diameter.
- To evaluate the efficacy and safety of this technique in patients with refractory hepatic encephalopathy.
Main Methods:
- A constrained stent-graft technique was employed using a commercially available balloon-expandable stent-graft narrowed with a lasso catheter.
- Five patients with TIPS-induced refractory hepatic encephalopathy were treated with this method.
Main Results:
- All procedures were technically successful.
- Significant increase in portosystemic gradient and reopacification of intrahepatic portal vein branches were observed.
- Clinical improvement correlated with procedural success.
Conclusions:
- This endovascular technique allows for adjustable reduction of shunt diameter.
- It provides a method to titrate the portosystemic gradient to a desired endpoint.
- This approach offers a promising option for managing TIPS-induced refractory hepatic encephalopathy.