Transjugular IntrahepaticPortosystemic Shunt (TIPS)

  • Medical Author:
    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical Editor: Bhupinder Anand, MD
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How is TIPS performed?

Unfortunately, one of the places varices form is in the stomach and lower esophagus, and these varices have a tendency to bleed massively, frequently causing death from exsanguination. By providing an artificial path for blood traveling from the intestines, through the liver, and back to the heart, the shunt placed during the TIPS procedure reduces the pressure in the portal vein (portal system), and tends to keep varices from forming.

There are several types of portosystemic shunts that are placed surgically, but TIPS is a non-surgical method of placing a portosystemic shunt. The shunt is passed down the jugular vein from the neck by a radiologist using X-ray guidance. The shunt then is inserted between the portal and hepatic veins within the liver.

What are the complications of TIPS?

There are two important complications of the TIPS procedure. The first is hepatic encephalopathy, a condition in which it is believed that 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. (The TIPS allows the toxin-containing blood to bypass the liver.) The effects on the brain can vary from minor alterations in thinking to full coma.

A second complication is heart failure due to the sudden increase in the amount of blood returning to the heart through the shunt. The heart is unable to pump the returning blood fast enough, resulting in heart failure.

Finally, one complication may be caused by the shunt itself; problems such as infection and shunt occlusion, requiring placement of another shunt.

Medically reviewed by Martin E. Zipser, MD; American board of Surgery

REFERENCE: Transjugular Intrahepatic Portosystemic Shunt.

Medically Reviewed by a Doctor on 6/3/2015

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