Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Apr 28, 2017; 9(12): 603-612
Published online Apr 28, 2017. doi: 10.4254/wjh.v9.i12.603
Passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts and assessment of clinical outcomes
Michael C Hsu, Charles N Weber, S William Stavropoulos, Timothy W Clark, Scott O Trerotola, Richard D Shlansky-Goldberg, Michael C Soulen, Gregory J Nadolski
Michael C Hsu, Department of Radiology, Division of Interventional Radiology, Mount Sinai Hospital, New York, NY 10128, United States
Michael C Hsu, Charles N Weber, S William Stavropoulos, Timothy W Clark, Scott O Trerotola, Richard D Shlansky-Goldberg, Michael C Soulen, Gregory J Nadolski, Department of Radiology, Division of Interventional Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, United States
Author contributions: Hsu MC, Weber CN and Nadolski GJ designed the study, performed the data analysis, and wrote the manuscript; Stavropoulos SW, Clark TW, Trerotola SO, Shlansky-Goldberg RD and Soulen MC performed the majority of the procedures and were involved in editing the manuscript.
Institutional review board statement: Institutional review board approval was obtained for this study. Given the design involves retrospective review of previously collected data obtained during clinical care of the patients, IRB approval was granted using an expedited review process.
Informed consent statement: Waiver of consent was granted by the IRB given the retrospective design and reporting of results in aggregate without inclusion of individual patient identifiers.
Conflict-of-interest statement: None of the authors has any conflict of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Michael C Hsu, MD, Department of Radiology, Division of Interventional Radiology, Mount Sinai Hospital, 215 East 95th St. Apt. 5L, New York, NY 10128, United States. hsu.mike.c@gmail.com
Telephone: +1-804-8523428 Fax: +1-212-4267745
Received: October 26, 2016
Peer-review started: October 27, 2016
First decision: December 29, 2016
Revised: January 26, 2017
Accepted: March 12, 2017
Article in press: March 13, 2017
Published online: April 28, 2017
Core Tip

Core tip: Sub-maximal dilation of transjugular intrahepatic portosystemic shunts (TIPS) is a method to reduce the risk of over-shunting and hepatic encephalopathy. The current study is a retrospective review to compare clinical outcomes of sub-maximally dilated TIPS (smTIPS) with maximally dilated TIPS (mTIPS) and assess for passive expansion of smTIPS. The study demonstrated that passive expansion of smTIPS does occur, however shunts may not fully expand and expansion may occur even after 6 mo. Clinical outcomes of smTIPS and mTIPS were similar, suggesting sub-maximal dilation may be an acceptable method to prevent complications related to over-shunting in select patients.