Initial underdilation of transjugular intrahepatic portosystemic shunt (TIPS) stents has been a widely proposed and commonly practiced technique to balance portal hypertension relief and the adverse effects associated with excess shunting, especially hepatic encephalopathy. However, this technique has been scrutinized by a number of studies which have shown that underdilated TIPS stents tend to passively expand with time. The recently launched GORE® VIATORR® TIPS Endoprosthesis with Controlled Expansion (VIATORR CX®) may address this problem with its novel diameter control capabilities. This article reviews literature concerning passive expansion of initially underdilated TIPS stents and explores preliminary data investigating the use and efficacy of the VIATORR CX® endoprosthesis.
Blood Vessel Prosthesis ; Hepatic Encephalopathy ; Hypertension, Portal ; Portasystemic Shunt, Surgical ; Stents