DEVELOPMENT OF STENOSES IN TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNTS

PURPOSE: To evaluate the frequency and significance of stenoses or occ lusions developing within transjugular intrahepatic portosystemic shun ts (TIPS) and identify predictive factors. MATERIALS AND METHODS: Medi cal records of 52 patients who underwent TIPS placement between Septem ber 1991 and October 1993 were reviewed. Various shunt parameters were correlated with the development of shunt abnormalities. Findings at f ollow-up portography and frequency of variceal bleeding and paracentes is were also noted. RESULTS: Twenty-four patients were followed up for at least 6 months. In eight patients, stenoses developed within 6 mon ths; one shunt occluded. No clear correlations were found between shun t parameters and development of shunt abnormalities. Two of four patie nts with recurrent variceal bleeding had associated shunt abnormalitie s. The frequency of stenosis of TIPS was high. CONCLUSION: Early detec tion and prompt revision of stenotic shunts may decrease the frequency of recurrent variceal bleeding and ascites.