Transjugular intrahepatic
portosystemic shunt (
TIPS) surgery is a clinical intervention to treat
portal hypertension (PH) by deploying a covered
stent to establish a shunt path for the portal vein (PV) system, and proper surgical strategy is of great importance to balance the shunt effect and the risk of complications. To understand the clinical strategies of the
stent blind insertion and
stent selection in clinic, this study investigated the effects of varying
stent insertion positions and diameters on the PV hemodynamics and the shunt effect by computational fluid dynamics (CFD) analysis of five post-
TIPS subjects. The results showed that the successful
TIPS surgeries of the five PH subjects were confirmed by quantifying their pressure drops. The
stent insertion positions at the main portal vein (MPV) slightly affected the clinically concerned hemodynamic indexes (i.e., MPV pressure,
stent-outlet velocity) and the shunt index (SI). This indicated that the position of the
stent going into the MPV may not need to be deliberately selected. Moreover, the covered
stents with 6 mm and 8 mm diameters slightly influenced the hemodynamics as well, but the large-diameter
stent better improved the shunt effect compared to the small-diameter one. Despite this, the 6 mm
stent was suggested thanks to the higher risk of the
hepatic encephalopathy (HE) observed in clinic, which indicated the excessive shunt of the 8 mm
stent. The current work revealed the effects of different
TIPS strategies on the surgical outcome, and could be useful for potential clinical practices.