transjugular intrahepatic portosystemic stent-shunt

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TIPS Hepatology A minimally invasive portosystemic shunt for portal HTN and bleeding complications due to liver disease–eg, esophageal varices Indications Esophageal varices that bleed after endoscopic banding, sclerotherapy, or surgical portosystemic shunt; refractory ascites, hepatic venoocclusive disease or Budd-Chiari syndrome Complications Hemorrhage, stenosis, occlusion–intraabdominal, biliary, subcapsular; stent migration, contrast-induced renal failure, pulmonary edema, hepatic infarction, hepatic arterial injury, gallbladder puncture, stent malpositions, hemobilia, hemolysis, fever, sepsis, hemoperitoneum, radiation injury, entry site hematoma, subcapsular hematoma, encephalopathy, liver failure Outcome Hepatic encephalopathy 25%; 18% rebleed at 1 yr; 85% one-yr survival

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