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Liver failure after TIPS. (A) Direct portogram in a patient who underwent a TIPS procedure for the management of refractory ascites. Shortly after TIPS he had a significant elevation of total serum bilirubin and liver enzymes. The patient was not a transplant candidate. Reducing stent placement was requested. (B) A reducing stent was created with a Wallgraft and placed within the patent shunt. The portogram shows successful shunt reduction after reducing stent placement.
