TIPS; Percutaneous shunting
Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure to treat complications of severe liver disease by diverting blood away from the blood vessels in the liver.
The procedure is typically performed by radiologists. Many patients receive a local pain-killing medicine (anesthesia) to numb a small area of the skin and a sedative to relax them (conscious sedation), as well as pain medications. In certain cases, general anesthesia (where the patient is asleep) may be used.
A needle is placed in the jugular vein in the right side of the neck to make a small hole. Needles and long, thin tubes called catheters can then be placed through the neck into veins in the liver.
A needle is inserted to make a connection between a branch of the vein that carries blood to the liver (portal vein) and another vein in the liver. This channel is then expanded. A tube called a stent is inserted to allow blood to flow more easily through the liver. This tube is left in place.
Complications of severe liver disease can include bleeding from the esophagus or stomach, and build-up of fluid in the abdomen, which are caused by high pressure in the blood vessels (portal veins) of the liver.
The purpose of this procedure is to send blood away from these veins. This relieves the pressure of blood flowing through the diseased liver and can help stop bleeding and fluid back-up.
This procedure is used if you have not responded to less invasive treatments (such as salt restriction in the diet, medications called diuretics to remove fluid, and fluid drainage). This may include bleeding from esophageal varices.
LaBerge JM. Transjugular intrahepatic portosystemic shunt--role in treating intractable variceal bleeding, ascites, and hepatic hydrothorax. Clin Liver Dis. 2006;10:583-598.