Stent-grafts for the treatment of TIPS dysfunction: Fluency stent vs Wallgraft stent

Figure 1 Portal venograms in a 52-year-old woman with hepatitis B cirrhosis who was treated with transjugular intrahepatic portosystemic shunt for recurrent variceal bleeding. A: Portography after crossing the previous shunt shows a patent splenic vein and the occluded main portal vein with cavernous transformation; B: After implantation with a Fluency stent, the portosystemic pressure gradient was reduced from 31 to 11 mmHg.

Figure 2 Portal venograms in a 45-year-old man with hepatitis B cirrhosis who had undergone transjugular intrahepatic portosystemic shunt for repeated variceal bleeding. A: The anteroposterior portal venogram obtained 5 mo after the initial transjugular intrahepatic portosystemic shunt procedure shows the complete occlusion of the stent and opacification of a massive spontaneous splenorenal shunt; B: Embolization of the splenorenal shunt was performed to maintain sufficient portal flow to keep the stent open. The portal venogram after Wallgraft stent placement reveals a wide patent shunt. The portosystemic pressure gradient decreased from 37 to 10 mmHg.

Figure 3 The probability of remaining free of shunt dysfunction.