In Reply to: Re: Case 0599_03--TIPS for Budd-Chiari: Late Follow Up and Management posted by Bret N Wiechmann, MD on May 28, 1999 at 23:01:28:
In general terms,if your patient is appropriately anticoagulated for the underlying cause of her B-C syndrome and continues to develop recurrent tract stenoses, then a stent graft may be a reasonable next step. As an aside, the fact that you have not been able to demonstrate a bile leak does not guarantee its absence--they are harder to demonstrate when a shunt is patent but stenotic.
I've stent-grafted about over 14 patients with ePTFE stent grafts at the time of initial TIPS or for revision of failing shunts and the reasons have been splendid, at a mean follow up of about 20 months.
I expect that this fall, we may see U.S. trials of commercial TIPS endografts.