The Transjugular Intrahepatic Portosystemic Stent-Shunt Procedure for Variceal Bleeding

After experimental studies, 1 , 2 intrahepatic portosystemic shunts were established in patients by balloon dilation of tissue between portal and hepatic veins 3 , 4 . The results were disappointing, because most patients soon died with recurrent bleeding. Balloon dilation of the tissue tract was not sufficient to maintain effective portal decompression and portosystemic shunting. This problem was solved by introducing expandable stents designed to keep the shunt patent. Studies in animals 5 , 6 had demonstrated the efficacy and patency of expandable stents. Shunting with a transjugular intrahepatic portosystemic stent has been performed in patients for over five years 7 – 11 . The procedure has . . .