Transjugular Intrahepatic Portosystemic Shunt (TIPS) for Cirrhosis

Topic Overview

Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure that may be used to reduce portal hypertension and its complications, especially variceal bleeding. A TIPS procedure may be done by a radiologist, who places a small wire-mesh coil (stent) into a liver vein. The stent is then expanded using a small inflatable balloon (angioplasty). The stent forms a channel, or shunt, that bypasses the liver. This channel reduces pressure in the portal vein. By reducing portal hypertension, enlarged veins (varices) are less likely to rupture and bleed. And other complications of cirrhosis called ascites (fluid in the abdomen) and hepatic hydrothorax (fluid between the lungs and the chest wall) may improve or go away.

TIPS may be used to:

• Treat fluid buildup that continues to occur in the abdominal cavity despite medical therapy (refractory ascites).
• Treat acute variceal bleeding that is not controlled by standard treatment.
• Prevent recurrent episodes of variceal bleeding when sclerotherapy or band ligation has failed.
• Treat variceal bleeding while someone is waiting for a liver transplant.

Complications of the procedure may include:

• Encephalopathy. Up to 20 out of 100 people who have TIPS surgery develop encephalopathy after the surgery.^{footnote 1}
• Malfunction of the stent, such as narrowing (stenosis) or closing (occlusion).