Short- and long-term evolution of the endoluminal diameter of underdilated stents in transjugular intrahepatic portosystemic shunt.

Abstract Purpose The purpose of this study was to evaluate the short- and long-term evolution of endoluminal diameter of covered metallic stents that were underdilated at the time of transjugular intrahepatic portosystemic shunt (TIPS) creation. Materiel and methods Sixteen patients (13 men, 3 women) with a mean age of 57.6 years ± 7.9 (SD) were retrospectively included. All patients had had TIPS creation using a 10-mm diameter covered stent (VIATORR ® ) that was underdilated (i.e., 8 mm) at the time of stent placement. Measurements of the mean circulating diameter of the stents were retrospectively performed on angiographic examinations every 6 months up to 2 years. Results The endoluminal stent diameter early enlarged from 8.96 mm ± 1.12 (SD) to 10 mm ± 1.45 (SD) after 6 months ( P  = 0.04) with no further significant changes over time after 12 months (10.28 mm ± 1.9 mm), 18 months (9.93 ± 1.51 mm) and 24 months (9.92 ± 0.9 mm). Conclusion Our results demonstrate a passive expansion of initially underdilated covered stents during the six months following TIPS creation. This should be taken into account regarding hepatic encephalopathy prevention during TIPS placement.