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| 1 | Passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts and assessment of clinical outcomes显示文摘AIM To assess for passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts(TIPS) and compare outcomes with maximally dilated TIPS.METHODS Polytetrafluoroethylene covered TIPS(Viatorr) from July 2002 to December 2013 were retrospectively reviewed at two hospitals in a single institution. Two hundred and thirty patients had TIPS maximally dilated to 10 mm(m TIPS), while 43 patients who were at increased risk for hepatic encephalopathy(HE), based on clinical evaluation or low pre-TIPS portosystemic gradient(PSG), had 10 mm TIPS sub-maximally dilated to 8 mm(sm TIPS). Group characteristics(age, gender, Model for End-Stage Liver Disease score, post-TIPS PSG and clinical outcomes were compared between groups, including clinical success(ascites or varices), primary patency,primary assisted patency, and severe post-TIPS HE. A subset of fourteen patients with sm TIPS underwent follow-up computed tomography imaging after TIPS creation, and were grouped based on time of imaging(< 6 mo and > 6 mo). Change in diameter and crosssectional area were measured with 3D imaging software to evaluate for passive expansion.RESULTS Patient characteristics were similar between the sm TIPS and m TIPS groups, except for pre-TIPS portosystemic gradient, which was lower in the sm TIPS group(19.4 mm Hg ± 6.8 vs 22.4 mm Hg ± 7.1, P = 0.01). Primary patency and primary assisted patency between sm TIPS and m TIPS was not significantly different(P = 0.64 and 0.55, respectively). Four of the 55 patients(7%) with sm TIPS required TIPS reduction for severe refractory HE, while this occurred in 6 of the 218 patients(3%) with m TIPS(P = 0.12). For the 14 patients with follow-up computed tomography(CT) imaging, the median imaging follow-up was 373 d. There was an increase in median TIPS diameter, median percent diameter change, median area, and median percent area change in patients with CT follow-up greater than 6 mo after TIPS placement compared to follow-up within 6 mo(8.45 mm, 5.58%, 56.04 mm^2, and 11.48%, respectively, P = 0.01).CONCLUSION Passive expansion of sm TIPS does occur but clinical outcomes of sm TIPS and m TIPS were similar. Sub-maximal dilation can prevent complications related to overshunting in select patients. | Michael C Hsu Charles N Weber S William Stavropoulos Timothy W Clark Scott O Trerotola Richard D Shlansky Goldberg Michael C Soulen Gregory J Nadolski | 2017 | World Journal of Hepatology2017，9，12： | 11 |
| 2 | A new hybrid Genetic Algorithm for global optilnization显示文摘 | Sotiropoulos D G Stavropoulos E C | 1997 | Nonlinear Analysis Theory Methods and Applications1997，30，7： | 1 |
| 3 | Druginduced pemphigoid:a review of the literature显示文摘 | Stavropoulos PG Soura E Antoniou C | 2014 | J Eur Acad Dermatol Venereol2014，28，9： | 1 |
| 4 | Symmetric lipomatosis in female patients显示文摘 | Stavropoulos P G Zouboulis C C Trautmann C | 1997 | Dematolo- gy1997，194，1： | 1 |
| 5 | HLA-B * 5101 in Greek patients with Behcet' s disease 显示文摘 | Koumantaki Y Stavropoulos C Spyropoulou M | 1998 | Hum Immunol1998，59，： | 1 |
| 6 | An enhanced packaging system for helper-dependent herpes simplex virus vectors显示文摘 | Stavropoulos T A Strathdee C A | 1998 | J Virol1998，72，： | 1 |
| 7 | A new hybrid genetic algorithm for global optimization显示文摘 | SOTIROPOULOS D G STAVROPOULOS E C VRAHATIS M N | 1997 | Nonlinear Analysis1997，30，7： | 1 |
| 8 | Prognostic significance of angiogenesis in superficial bladder cancer显示文摘 | Stavropoulos NE Bouropoulos C Ioachim IE | 2004 | Int Urol Nephrol2004，36，2： | 1 |
| 9 | Prognostic significance of angiogenesis in superficial bladder cancer显示文摘 | Stavropoulos N E Bouropoulos C Ioachim I E | 2001 | Int Urol Nephrol2001，36，： | 1 |
| 10 | Calibration measurements in laser-induced breakdown spectroscopy using nanosecond and picosecond lasers显示文摘 | Stavropoulos P Palagas C Angelopoulos G N | 2004 | Spectrochimica Acta Part B2004，59，12： | 1 |
| 11 | Symmetric lipom atosis in female patients显示文摘 | Stavropoulos PG Zouboulis CC Traumann C | 1997 | Dematology1997，194，1： | 1 |
| 12 | Symmetric lipom atosis in female patients 显示文摘 | Stavropoulos P G Zouboulis C C Traumann C | 1997 | Dematology1997，194，1： | 1 |
| 13 | Babesiosis, asplenia, and AIDS显示文摘 | Ong K R Stavropoulos C Inada Y | 1990 | Lancet1990，336，： | 1 |
| 14 | Calibration measurements in laser-induced breakdown spectroscopy using nanosecond and picosecond laser显示文摘 | Stavropoulos P Palagas C Angelopoulos G N | 2004 | Spectrochimica Acta Part B2004，59，12： | 1 |
| 15 | A new hybrid genetic algorithm for global optimization 显示文摘 | Sotiropoulos D G Stavropoulos E C | 1997 | Nonlinear Analysis Theory Methods and Applications1997，30，7： | 1 |
| 16 | Transdiaphragmatic amyloidoma 显示文摘 | Rosen D J Stavropoulos C Travis W D | 2008 | Ann Thorac Surg2008，86，1： | 1 |
| 17 | An enhanced packaging system for helper-dependent herpes simplex virus vectors显示文摘 | Stavropoulos T A Strathdee C A | 1998 | J Virol1998，72，： | 1 |
| 18 | Antimycobacterial calixarenes enhance innate defense mechanisms in murine macrophages and induce control of mycobacterium tuberculosis infection in mice显示文摘 | Colston M J Hailes H C Stavropoulos E | 2004 | Infection and Immunity2004，72，11： | 1 |
| 19 | Computer controlled interactive video multimedia suthoring systems显示文摘 | Drman A C S Stavropoulos NA Labat L | 1996 | Genumics1996，37，： | 1 |
| 20 | A comparative study of barrier membranes as graft protectors in the treatment of localized bone defects显示文摘 | Stavropoulos F Dahlin C Ruskin J D | 2004 | Clin Oral Implan RES2004，15，4： | 1 |
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