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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 | Micrometastases in esophagogastric cancer:high detection rate in resected rib segments显示文摘 | O'SULLIVAN G C SHEEHAN D CLARKE A | 1999 | Gastroenterology1999，116，3： | 1 |
| 3 | The rhesus macaque as an animal model for pelvic organ peolapse显示文摘 | Otto L N Slayden O D Clark A L | 2002 | Am J Obstet Gynecol2002，186，33： | 1 |
| 4 | Evaluation of digital and film hemispherical photography and spherical deusitometry for measuring forest light environments显示文摘 | Englund S R O'Brien J J Clark D B | 2000 | Canadian Journal of Forest Research2000，30，12： | 1 |
| 5 | Model checking and abstraction显示文摘 | Clarke E M Grumberg O Long D E | 1993 | ACM Transaction on Programming Languages and Systems1993，16，5： | 1 |
| 6 | Genetic engineering of ethanol production in Escherichia coli 显示文摘 | Ingrain L O Conway T Clark D P | 1987 | Appl Environ Microbiol1987，53，10： | 1 |
| 7 | Relationship between cytokine levels and coronary artery disease in women显示文摘 | Batuman O Go D ClaRk LT | 2001 | Heatr Dis2001，3，2： | 1 |
| 8 | Vulpes ferrilata显示文摘 | Clark H O Jr D P Newman J D | 2008 | Mammalian Species2008，821，： | 1 |
| 9 | The IRT1 protein from Arabidopsis thaliana is a metal transporter with a broad substrate range显示文摘 | Korshunova Y O Eide D Clark W G | 1999 | Plant Mol Biol1999，40，： | 1 |
| 10 | Polyunsaturated fatty acids inhibit S14 gene transcription inrat liver and cultured hepatocytes 显示文摘 | Jump D B Clarke S D MacDougald O | 1993 | PNAS1993，90，18： | 1 |
| 11 | Factors Influencing Willingness -to -pay for the ENERGY STAR Label显示文摘 | WARD D O CLARK C D JENSEN K L | 2011 | Energy Policy2011，39，3： | 1 |
| 12 | Automatic target recognition by matching oriented edge pixels 显示文摘 | CLARK F O HUTTENLOCHER D P | 1997 | IEEE Transactions on Image Processing1997，6，1： | 1 |
| 13 | Enhanced expression of heat shock protein 27is correlated with axonal regeneration in mature retinal ganglion cells显示文摘 | Hebb M O Myers T L Clarke D B | 2006 | Brain Research2006，，3： | 1 |
| 14 | Micrometastases in es ophagogastric cancer: high detection rate in resected rib segments显示文摘 | O SULLIVAN GC SHEEHAN D CLARKE A | 1999 | Gastroe nterology1999，116，： | 1 |
| 15 | U87MG decoded:the genomic sequence of a cytogenetically aberrant human cancer cell line显示文摘 | Clark M J Homer N O'Connor B D | 2010 | PLoS Genet2010，6，10： | 1 |
| 16 | Estimation of tropical forest structural characteristics using large-footprint LiDAR显示文摘 | DRAKE J B DUBAYAH R O CLARK D B | 2002 | Remote Sensing of Environment2002，79，： | 1 |
| 17 | Model checking and abstraction显示文摘 | Clarke E M Grumberg O Long D E | 1994 | ACM Transactions on Programming Languages and System1994，16，5： | 1 |
| 18 | The IRT1 protein from Arabidopsis thaliana is a metal transporter with a broad substrate range显示文摘 | KORSHUNOVA Y O EIDE D J CLARK W G GUERINOT M L PAKRASI H B | 1999 | Plant Molecular Biology1999，40，1： | 1 |
| 19 | Model checking and abstraction 显示文摘 | CLARKE E M GRUMBERG O LONG D E | 1994 | ACM Transactions on Programming Languages and Systems1994，16，5： | 1 |
| 20 | Model checking and abstraction显示文摘 | E M CLARKE O GMMBERG D E LONG | 1994 | ACM Transactions on Programming Langua- ges and Systems1994，16，5： | 1 |
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