TIPS Procedure

1 What is a Transjugular Intrahepatic Portosystemic Shunt (TIPS)?

Transjugular intrahepatic portosystemic shunt (TIPS) is a tube (shunt) placed between the portal vein, which carries blood from the intestines and intraabdominal organs to the liver and the hepatic vein which carries blood from the liver back to the vena cava and the heart.

It is used in patients with portal hypertension – an increased pressure within the portal vein by a blockage in the blood flow through the liver. The most common cause of portal hypertension is cirrhosis in which the scar tissue on the liver causes the partial flow of blood passing through the liver from the portal vein to the hepatic vein.

If these veins, which go to the other organs enlarge, they are referred to as variceal veins or varices which can rupture and bleed massively in the stomach and esophagus, frequently causing death from exsanguinations.

TIPS is a non-surgical method of placing a portosystemic shunt down the jugular vein from the neck between the portal and hepatic veins within the liver. The procedure is done by a radiologist using X-ray guidance.

Two important complications of the TIPS procedure which can occur are:

  • Hepatic encephalopathy – Toxic products from the intestines (for example, ammonia) that are normally removed from the blood by the liver remain in the blood and are delivered to the brain and the effects on the brain can vary from minor alterations in thinking to full coma.
  • Heart failure – Due to the sudden increase in the amount of blood returning to the heart through the shunt so the heart is unable to pump the returning blood fast enough, resulting in heart failure.
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