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Transjugular intrahepatic portosystemic shunt (TIPS)

Alternative Names:

TIPS

Definition:

Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure to treat complications of severe liver disease. Such complications include bleeding from the esophagus or stomach and the accumulation of fluid in the abdomen. The cause of these complications is high pressure in blood vessels of the liver called portal veins.

The procedure involves inserting a stent (tube) to connect the portal veins to adjacent blood vessels that have lower pressure. This relieves the pressure of blood flowing through the diseased liver and can help stop bleeding and fluid back up.

Description:

The procedure is typically performed by radiologists. Many patients receive a local anesthesia to numb a small area of the skin plus sedative and pain medications. In certain cases, general anesthesia may be used, where the patient goes to sleep.

A needle is initially 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 advanced down to the veins in the liver.

A needle is inserted to make a connection between an adjacent vein and a branch of the portal vein. This channel is then expanded, and a tube called a stent is inserted to allow blood to flow more easily through the liver. This tube is left in place.

Indications:

This procedure is used to treat complications of severe liver disease, when the patient has not responded to less invasive treatments (such as salt restriction in the diet and medications called diuretics to remove fluid).

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