Zhou TY, Wang HL, Tao GF, Chen SQ. Stent fracture after transjugular intrahepatic portosystemic shunt: A case report. World J Gastrointest Surg 2025; 17(5): 104893 [DOI: 10.4240/wjgs.v17.i5.104893]
Corresponding Author of This Article
Tan-Yang Zhou, PhD, Doctor, Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Shangcheng District, Hangzhou 310003, Zhejiang Province, China. 1512037@zju.edu.cn
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Tan-Yang Zhou, Hong-Liang Wang, Sheng-Qun Chen, Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Guo-Fang Tao, Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Zhou TY contributed to conceptualization, data curation, visualization, writing original draft, writing review and editing; Wang HL and Chen SQ contributed to data curation, supervision, visualization, writing review and editing; Tao GF contributed to conceptualization, supervision, visualization, writing review and editing.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tan-Yang Zhou, PhD, Doctor, Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Shangcheng District, Hangzhou 310003, Zhejiang Province, China. 1512037@zju.edu.cn
Received: January 15, 2025 Revised: March 8, 2025 Accepted: April 7, 2025 Published online: May 27, 2025 Processing time: 128 Days and 11.6 Hours
Abstract
BACKGROUND
Transjugular intrahepatic portosystemic shunt (TIPS) is a highly effective treatment for complications associated with portal hypertension. However, stent fracture, although extremely rare, represents a potentially serious complication following TIPS creation. Timely identification and management are crucial for preventing further adverse events.
CASE SUMMARY
We report a 56-year-old male patient who underwent a TIPS procedure for recurrent melena caused by portal hypertension secondary to hepatitis B and experienced a stent fracture 15 months post-procedure. He was readmitted 30 months after the initial TIPS due to recurrent esophagogastric variceal bleeding and ascites. An attempt to revise the dysfunctional shunt via a stent-in-stent approach was unsuccessful. Consequently, a parallel TIPS procedure was successfully performed via the proximal end of the fractured stent to decompress the portal venous system. At the 1-month follow-up, the patient exhibited no recurrent variceal bleeding, and his ascites had significantly decreased. Twelve-month postoperative monitoring revealed no hepatic encephalopathy and no recurrence of bleeding or ascites. Additionally, we review the existing literature on post-TIPS stent fractures to explore the underlying mechanisms contributing to this complication.
CONCLUSION
Early recognition and prompt intervention are essential in managing stent fractures after TIPS creation to mitigate potential risks and ensure optimal patient outcomes.
Core Tip: Stent fracture is an uncommon yet a potentially serious complication following transjugular intrahepatic portosystemic shunt (TIPS), particularly among the bare metal stent/stent-graft combination. The optimal approach for managing stent fractures has not yet reached a consensus. The embedding of a second stent, surgery, and parallel TIPS are currently the most common methods used for managing stent fractures. Early recognition and prompt intervention are essential in managing stent fractures after TIPS to mitigate potential risks and ensure optimal patient outcomes.
