Passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts and assessment of clinical outcomes

Table 1 Demographics and clinical characteristics

	Sub-maximally dilated	Maximally dilated	P value
Total patients	43	230	NA
Male	23	150	0.17
Female	20	80
Mean age (yr)	56.5 ± 2.3 (range 10-83)	54.5 ± 0.7 (range 20-81)	0.29
Mean MELD	13.6 ± 0.6 (range 6-25)	13.5 ± 0.3 (range 6-28)	0.82
Mean pre-TIPS PSG (mmHg)	19.4 ± 6.8 (range 8-45)	22.4 ± 7.1 (range 9-73)	0.01
Median post-TIPS PSG (mmHg)	8 (range 1-13)	8 (range 2-20)	0.13
Mean percent change in PSG (%)	59.1 ± 15.9 (range 0-95)	61.0 ± 12.4 (range 0-89)	0.53

MELD: Model for end-stage liver disease; TIPS: Transjugular intrahepatic portosystemic shunt; PSG: Portosystemic gradient; NA: Not applicable.

Table 2 Mean pre-transjugular intrahepatic portosystemic shunt portosystemic gradient and percent change in portosystemic gradient in patients with post-transjugular intrahepatic portosystemic shunt portosystemic gradient above and below 12 mmHg

	> 12 mmHg	≤ 12 mmHg	P value
Mean pre-TIPS PSG (mmHg)	33 ± 13.2 (range 20-73)	21.1 ± 5.7 (range 8-53)	< 0.01
Mean percent change in PSG (%)	48.3 ± 13.1 (range 30.8-82.2)	61.6 ± 12.6 (range 0-95)	< 0.01

TIPS: Transjugular intrahepatic portosystemic shunt; PSG: Portosystemic gradient.

Table 3 Measurements of 8 mm transjugular intrahepatic portosystemic shunt stents on computed tomography imaging follow-up

	Median diameter (mm)	Median percent diameter change	Median area (mm2)	Median percent area change
< 6 mo (n = 7)	8.05 (range 7.84-8.43)	0.67%	50.94	1.34%
> 6 mo (n = 7)	8.45 (range 8.23-8.72)	5.58%	56.04	11.48%
P-value	0.01	0.01%	0.01	0.01%

Table 4 Clinical Success of transjugular intrahepatic portosystemic shunt n (%)

	Sub-maximally dilated	Maximally dilated	P value
Complete Clinical Success of TIPS for Ascites
Yes	9 (64)	63 (64)	1
No	5 (36)	35 (36)
Partial Clinical Success of TIPS for Ascites
Yes	11 (79)	89 (91)	0.17
No	3 (21)	9 (9)
Clinical Success of TIPS for Varices
Yes	7 (78)	64 (85)	0.62
No	2 (22)	11 (15)

TIPS: Transjugular intrahepatic portosystemic shunt.

Table 5 Severe post- transjugular intrahepatic portosystemic shunt hepatic encephalopathy n (%)

Severe post-TIPS HE	Sub-maximally dilated	Maximally dilated	P value
Yes	4 (7)	6 (3)	0.12
No	51 (93)	212 (97)

TIPS: Transjugular intrahepatic portosystemic shunt; HE: Hepatic encephalopathy.

Table 6 Model for End-Stage Liver Disease and post-transjugular intrahepatic portosystemic shunt portosystemic gradient for patients with and without severe post-transjugular intrahepatic portosystemic shunt hepatic encephalopathy

	Mean MELD with HE	Mean MELD without HE	P value	Median post-TIPS PSG with HE (mmHg)	Median post-TIPS PSG without HE (mmHg)	P value
Sub-maximally dilated	13.3 ± 2.9 (range 11-17)	13.7 ± 4.3 (range 6-25)	0.85	7.5 (range 6-8)	8 (range 1-13)	0.67
Maximally dilated	15.8 ± 4.3 (range 12-24)	13.4 ± 4.1 (range 6-28)	0.16	10 (range 4-11)	8 (range 2-20)	0.36

MELD: Model for End-Stage Liver Disease; HE: Hepatic encephalopathy; TIPS: Transjugular intrahepatic portosystemic shunt; PSG: Portosystemic gradient.