Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Dec 7, 2026; 32(45): 121243
Published online Dec 7, 2026. doi: 10.3748/wjg.121243
Published online Dec 7, 2026. doi: 10.3748/wjg.121243
Association of smaller-diameter underdilation of transjugular intrahepatic portosystemic shunt stents with improved long-term survival: A propensity score-matched study
Wen-Qing Zhang, Fan Yang, Lei Zhang, Hua Jiang, Song-Wei Li, Department of Interventional Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China
Ke-Jia Li, Department of Pharmacy, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China
Guang-Jin Jiang, Department of Radiology, The Second People’s Hospital of Baoshan, Baoshan 678000, Yunnan Province, China
Hao Guo, Department of Radiology, The People’s Hospital of Simao District (Pu’er Central Hospital), Pu’er 665000, Yunnan Province, China
Co-first authors: Wen-Qing Zhang and Ke-Jia Li.
Author contributions: Zhang WQ performed the statistical analysis and wrote the original manuscript; Li KJ participated in the study design, provided postoperative medication guidance, revised the manuscript according to reviewers’ comments, and obtained the funding support; Yang F, Jiang GJ, Zhang L, and Guo H collected the data and conducted follow-up; Jiang H editing the figure; Li SW designed the study, supervised the research, performed the statistical analysis, reviewed the manuscript, and obtained the funding support. Zhang WQ and Li KJ contributed equally to the work as co-first authors. All authors have read and approve the final manuscript.
AI contribution statement: AI tools (specifically DeepSeek, Gemini, ChatGPT) were used solely for language polishing and code assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.
Supported by Scientific Research Fund of Yunnan Provincial Department of Education, No. 2024J0233; and Yunnan Fundamental Research Kunming Medical University Joint Projects, No. 202501AY070001-085.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the Second Affiliated Hospital of Kunming Medical University (Approval No. PJ-KY-2026-12).
Informed consent statement: According to the Declaration of Helsinki, informed consent requirements were waived due to the retrospective nature of the study design.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Song-Wei Li, MD, Associate Professor, Department of Interventional Radiology, The Second Affiliated Hospital of Kunming Medical University, No. 374 Dianmian Avenue, Wuhua District, Kunming 650101, Yunnan Province, China. lisongwei@kmmu.edu.cn
Received: March 27, 2026
Revised: May 19, 2026
Accepted: June 29, 2026
Published online: December 7, 2026
Processing time: 202 Days and 10.9 Hours
Revised: May 19, 2026
Accepted: June 29, 2026
Published online: December 7, 2026
Processing time: 202 Days and 10.9 Hours
Core Tip
Core Tip: In our study, underdilating an 8-mm expanded polytetrafluoroethylene-covered stent to ≤ 6 mm vs ≥ 7 mm during transjugular intrahepatic portosystemic shunt showed no significant differences regarding the incidences of postoperative rebleeding, shunt dysfunction, and overt hepatic encephalopathy; however, it substantially reduced the mortality risk in the ≤ 6 mm group. Underdilating the stent to ≤ 6 mm appears to recalibrate the risk-benefit balance during transjugular intrahepatic portosystemic shunt with 8-mm expanded polytetrafluoroethylene-covered stents, yielding superior mid-to-long-term survival benefits.