Transjugular Intrahepatic Portosystemic Shunt (TIPS)

Why would someone want/need this service performed?

Transjugular intrahepatic portosystemic shunt, commonly known as TIPS, is an image-guided procedure that connects the portal vein to the hepatic vein in the liver. A small metal device called a stent is placed to keep the connection open and allow it to bring blood draining from the bowel back to the heart while avoiding the liver. TIPS may successfully reduce internal bleeding in the stomach and esophagus in patients with cirrhosis and may also reduce the accumulation of fluid in the abdomen (ascites).

Description of Procedure:

You will be under general sedation or sedated for the procedure, which the interventional radiologist will carry out using fluoroscopy or ultrasound for guidance.

The interventional radiologist will puncture your jugular vein on the right side of your neck with a needle and will then insert a vascular sheath over a wire into the inferior vena cava. He or she will explore the hepatic vein with a catheter designed for this purpose.

The interventional radiologist will puncture the portal vein through the liver with a special needle and position a wire between the two veins. After the area has been dilated, a stent or stent graft will be placed between the portal and hepatic vein to create a lasting connection.

A TIPS procedure is used to treat the complications of portal hypertension, including:

• Varicocele bleeding from any of the veins that normally drain the stomach, esophagus or intestines into the liver

• Portal gastropathy, an engorgement of the veins in the wall of the stomach, which can cause severe bleeding

• Ascites, the accumulation of fluid in the abdomen

• Budd-Chiari syndrome, the blockage in one or more veins that carry blood from the liver back to the heart

What value is there in this procedure? 

Patients have often been suffering with chronic symptoms that cause a great deal of discomfort. This procedure, which can take around an hour, can dramatically change lives. This is a minimally invasive procedure with very little down time that can make a big difference.

Example of procedure: https://www.riaendovascular.com/2022/04/05/portal-vein-thrombosis-tips-treated-by-matt-gipson-md/