A 7-mm Covered TIPS Reduces Hepatic Encephalopathy Without Increasing Rebleeding in Cirrhotic Patients With Small Liver: A Randomized Study.
Liver IntSep 12, 2026
Clinical ResearchGastroenterology
Fuquan Liu, Kan Zhang, Yu Zhang et al.
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In 30 seconds
This multicenter randomized controlled trial evaluated the efficacy of 7-mm covered transjugular intrahepatic portosystemic shunts (TIPS) compared to 8-mm stents in cirrhotic patients with small livers. Among 184 patients, the 2-year cumulative incidence of overt hepatic encephalopathy (HE) was significantly lower in the 7-mm group at 21.4% versus 37.2% in the 8-mm group (p=0.02), with similar rates of shunt dysfunction and rebleeding.
Key findings
- The 2-year cumulative incidence of overt HE was 21.4% in the 7-mm group vs 37.2% in the 8-mm group (p=0.02).
- Rates of shunt dysfunction were similar between groups at 8.7% for both.
- 2-year rebleeding rates were comparable: 10.9% for 7-mm vs 9.8% for 8-mm (p=0.81).
- OLT-free survival rates were 91.3% for 7-mm and 88.0% for 8-mm (p=0.82).
Why it matters
The study suggests that using a 7-mm TIPS may reduce the risk of hepatic encephalopathy in cirrhotic patients with small livers, potentially improving patient outcomes without compromising shunt function or increasing rebleeding risk.