A technique to create a coaxial, self-expanding stent graft inside a constraining, bare-metal, balloon-expandable stent for transjugular intrahepatic portosystemic shunt (TIPS) reduction is described. The key steps are performed on a back table rather than inside the patient, and the resulting construct is deployed using standard unsheathing maneuvers. The construct was used in 4 patients to make 6 TIPS diameter reductions (mean postreduction diameter, 6 mm; range, 0–8 mm), all resulting in increases in the portosystemic pressure gradient (mean increase, 6 mm Hg; range, 1–19 mm Hg). On average, hepatic encephalopathy improved 1 point on the West Haven scale (range, 0–2).

描述了一种在约束性裸金属球囊扩张支架内创建同轴自扩张支架移植物的技术，用于经颈静脉肝内门体分流 (TIPS) 复位。关键步骤是在后面的桌子上而不是在患者体内进行，并且使用标准的拔出操作来部署所得的结构。该结构在 4 名患者中使用，进行 6 次 TIPS 直径减小（平均减小后直径，6 毫米；范围，0-8 毫米），所有这些都会导致门体压力梯度增加（平均增加，6 毫米汞柱；范围，1- 19 毫米汞柱）。平均而言，肝性脑病在 West Haven 量表（范围，0-2）上改善了 1 分。