Association of smaller-diameter underdilation of transjugular intrahepatic portosystemic shunt stents with improved long-term survival: A propensity score-matched study

doi:10.3748/wjg.121243

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

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

Table 1 Patient characteristics before and after propensity score matching, n (%)/mean ± SD

Variables	Before PSM			After PSM
Variables	≤ 6 mm (n = 90)	≥ 7 mm (n = 102)	P value	≤ 6 mm (n = 78)	≥ 7 mm (n = 78)	P value
Age (years)	56.36 ± 11.04	52.14 ± 10.27	0.007	54.74 ± 9.32	52.81 ± 10.85	0.234
Gender			0.021			0.402
Male	51 (56.7)	74 (72.5)		48 (61.5)	53 (67.9)
Female	39 (43.3)	28 (27.5)		30 (38.5)	25 (32.1)
BMI (kg/m²)	22.52 ± 2.74	22.75 ± 3.55	0.620	22.57 ± 2.79	22.82 ± 3.68	0.631
Etiology of cirrhosis			0.128			0.290
Hepatitis B	34 (37.8)	55 (53.9)		33 (42.3)	40 (51.3)
Hepatitis C	12 (13.3)	11 (10.8)		12 (15.4)	5 (6.4)
Alcoholic	11 (12.2)	12 (11.8)		9 (11.5)	9 (11.5)
Autoimmune hepatitis	10 (11.1)	11 (10.8)		7 (9.0)	11 (14.1)
Others	23 (25.6)	13 (12.7)		17 (21.8)	13 (16.7)
Indication for TIPS			0.032			1.000
Variceal bleeding	79 (87.8)	98 (96.1)		74 (94.9)	74 (94.9)
Refractory ascites or hydrothorax	11 (12.2)	4 (3.9)		4 (5.1)	4 (5.1)
Child-Pugh sore (IQR)	7 (6, 8)	7 (6, 8)	0.806	7 (6, 8)	7 (6, 8)	0.562
Child-Pugh grade			0.479			0.259
A	29 (32.2)	38 (37.3)		26 (33.3)	31 (39.7)
B	55 (61.1)	54 (52.9)		48 (61.5)	39 (50.0)
C	6 (6.7)	10 (9.8)		4 (5.1)	8 (10.3)
MELD score (IQR)	12 (10, 14)	11 (10, 14)	0.755	11 (9, 13)	11 (9, 13)	0.930
Liver cancer			0.043			0.148
Yes	4 (4.4)	13 (12.7)		4 (5.1)	9 (11.5)
No	86 (95.6)	89 (87.3)		74 (94.9)	69 (88.5)
Diabetes			0.409			0.848
Yes	24 (26.7)	22 (21.6)		18 (23.1)	17 (21.8)
No	66 (73.3)	80 (78.4)		60 (76.9)	61 (78.2)
Hypertension			0.046			0.101
Yes	18 (20.0)	10 (9.8)		14 (17.9)	7 (9.0)
No	72 (80.0)	92 (90.2)		64 (82.1)	71 (91.0)
Ascites			0.933			0.869
Yes	57 (63.3)	64 (62.7)		48 (61.5)	49 (62.8)
No	33 (36.7)	38 (37.3)		30 (38.5)	29 (37.2)
Ascites grade			0.999			0.942
No	33 (36.7)	38 (37.3)		30 (38.5)	29 (37.2)
Mild	23 (25.6)	26 (25.5)		22 (28.2)	21 (26.9)
Moderate	13 (14.4)	15 (14.7)		13 (16.7)	12 (15.4)
Large	21 (23.3)	23 (22.5)		13 (16.7)	16 (20.5)
Hydrothorax			0.637			0.298
Yes	28 (31.1)	35 (34.3)		21 (26.9)	27 (34.6)
No	62 (68.9)	67 (65.7)		57 (73.1)	51 (65.4)
PVT			0.920			0.591
Yes	25 (27.8)	29 (28.4)		23 (29.5)	20 (25.6)
No	65 (72.2)	73 (71.6)		55 (70.5)	58 (74.4)
Gastrorenal shunt			0.330			0.357
Yes	15 (16.7)	12 (11.8)		13 (16.7)	9 (11.5)
No	75 (83.3)	90 (88.2)		65 (83.3)	69 (88.5)
Post-TIPS PPG (mmHg), IQR	12 (9, 16)	11 (9, 15)	0.218	12 (9, 16)	10 (8, 14)	0.177
White blood cell (10⁹/L), IQR	2.69 (2.06, 4.07)	2.89 (2.24, 3.90)	0.708	2.64 (2.05, 4.07)	2.84 (2.04, 3.73)	0.980
Platelet (10⁹/L), IQR	70 (52, 98)	62 (45, 82)	0.064	67 (50, 88)	62 (45, 85)	0.235
Albumin (g/L), IQR	32.0 (29.2, 35.5)	32.2 (29.4, 36.4)	0.898	32.0 (29.5, 35.7)	32.6 (30.6, 36.6)	0.515
TBIL (μmol/L), IQR	21.6 (15.2, 28.9)	22.4 (15.1, 30.0)	0.576	21.2 (14.8, 28.9)	21.0 (14.9, 29.7)	0.801
Sodium (mmol/L), IQR	140.2 (138.1, 141.8)	139.7 (137.0, 141.4)	0.162	140.2 (138.2, 141.4)	140.1 (137.7, 141.2)	0.510
Creatinine (μmol/L), IQR	70 (57, 86)	71 (59, 81)	0.903	70 (57, 84)	70 (58, 80)	0.750
PT (seconds), IQR	15.9 (14.9, 17.3)	16.2 (15.1, 17.4)	0.341	15.9 (15.0, 17.1)	16.0 (15.0, 17.2)	0.572
INR (IQR)	1.30 (1.20, 1.44)	1.36 (1.21, 1.45)	0.254	1.30 (1.21, 1.44)	1.34 (1.20, 1.43)	0.530

PSM: Propensity score matching; BMI: Body mass index; TIPS: Transjugular intrahepatic portosystemic shunt; IQR: Interquartile range; MELD: Model for end-stage liver disease; PVT: Portal vein thrombosis; PPG: Portal pressure gradient; TBIL: Total bilirubin; PT: Prothrombin time; INR: International normalized ratio.

Full Size Table

Table 2 Outcome events before and after propensity score matching, n (%)

Variables	Before PSM			After PSM
Variables	≤ 6 mm (n = 90)	≥ 7 mm (n = 102)	P value	≤ 6 mm (n = 78)	≥ 7 mm (n = 78)	P value
OHE			0.748			0.355
Yes	22 (24.4)	27 (26.5)		17 (21.8)	22 (28.2)
No	68 (75.6)	75 (73.5)		61 (78.2)	56 (71.8)
Rebleeding			0.444			0.632
Yes	13 (14.4)	11 (10.8)		11 (14.1)	9 (11.5)
No	77 (85.6)	91 (89.2)		67 (85.9)	69 (88.5)
Shunt dysfunction			0.274			0.148
Yes	5 (5.6)	10 (9.8)		4 (5.1)	9 (11.5)
No	85 (94.4)	92 (90.2)		74 (94.9)	69 (88.5)
Death			0.012			0.003
Yes	15 (16.7)	33 (32.4)		11 (14.1)	27 (34.6)
No	75 (83.3)	69 (67.6)		67 (85.9)	51 (65.4)

PSM: Propensity score matching; OHE: Overt hepatic encephalopathy.

Full Size Table

Table 3 Prognostic factors identified via Cox regression after propensity score matching

Characteristics	Univariate		Multivariate
Characteristics	Hazard ratio (95%CI)	P value	Hazard ratio (95%CI)	P value
Age	1.031 (0.997-1.065)	0.075
Sex
Male	Reference
Female	0.534 (0.253-1.127)	0.100
BMI	0.999 (0.905-1.103)	0.982
Etiology of cirrhosis		0.584
Hepatitis B cirrhosis	Reference
Hepatitis C cirrhosis	0.606 (0.181-2.031)	0.417
Alcoholic cirrhosis	1.031 (0.416-2.555)	0.948
Autoimmune hepatitis	0.351 (0.082-1.499)	0.158
Others	0.714 (0.288-1.772)	0.468
Indication for TIPS
Variceal bleeding	Reference
Refractory ascites/hydrothorax	3.987 (1.552-10.244)	0.004
Child sore	1.363 (1.102-1.686)	0.004
Child-Pugh grade		0.001		0.039
A	Reference		Reference
B	1.795 (0.862-3.902)	0.140	0.864 (0.256-2.911)	0.813
C	6.203 (2.299-16.738)	0.000	2.759 (0.685-11.107)	0.153
MELD 3.0 score	1.118 (1.020-1.225)	0.017
Liver cancer
No	Reference		Reference
Yes	3.558 (1.558-8.124)	0.003	2.755 (1.129-6.721)	0.026
Diabetes
No	Reference
Yes	1.438 (0.713-2.901)	0.310
Hypertension
No	Reference
Yes	1.386 (0.579-3.319)	0.464
Ascites
No	Reference		Reference
Yes	2.556 (1.171-5.577)	0.018	3.894 (1.022-14.841)	0.046
Ascites grade		0.001
No	Reference
Mild	1.633 (0.630-4.234)	0.313
Moderate	1.838 (0.638-5.298)	0.260
Large	5.074 (2.150-11.979)	0.000
Hydrothorax
No	Reference
Yes	1.770 (0.928-3.375)	0.083
PVT
No	Reference
Yes	1.644 (0.850-3.179)	0.140
Post-TIPS PPG	0.988 (0.924-1.056)	0.716
Balloon diameter
≥ 7 mm	Reference		Reference
≤ 6 mm	0.430 (0.212-0.869)	0.019	0.422 (0.203-0.877)	0.021
Albumin	0.959 (0.906-1.015)	0.147
TBIL	1.019 (0.997-1.042)	0.095
Creatinine	1.001 (0.992-1.010)	0.854
PT	1.108 (0.927-1.324)	0.261
INR	4.130 (0.760-22.438)	0.100
White blood cell	1.001 (0.828-1.212)	0.988
Platelet	0.999 (0.993-1.005)	0.747

CI: Confidence interval; BMI: Body mass index; TIPS: Transjugular intrahepatic portosystemic shunt; MELD: Model for end-stage liver disease; PVT: Portal vein thrombosis; PPG: Portal pressure gradient; TBIL: Total bilirubin; PT: Prothrombin time; INR: International normalized ratio.

Full Size Table

Citation: Zhang WQ, Li KJ, Yang F, Jiang GJ, Zhang L, Jiang H, Guo H, Li SW. Association of smaller-diameter underdilation of transjugular intrahepatic portosystemic shunt stents with improved long-term survival: A propensity score-matched study. World J Gastroenterol 2026; 32(45): 121243
URL: https://www.wjgnet.com/1007-9327/full/v32/i45/121243.htm
DOI: https://dx.doi.org/10.3748/wjg.121243

Zhang WQ, Li KJ, Yang F, Jiang GJ, Zhang L, Jiang H, Guo H, Li SW. Association of smaller-diameter underdilation of transjugular intrahepatic portosystemic shunt stents with improved long-term survival: A propensity score-matched study. World J Gastroenterol 2026; 32(45): 121243 [DOI: 10.3748/wjg.121243]

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