Transjugular Intrahepatic Portosystemic Shunt (TIPS)

What is a TIPS Procedure?

A transjugular intrahepatic portosystemic shunt, also referred to as a TIPS procedure used to treat several hepatic conditions such as recurrent ascites, portal hypertension and variceal bleeding.  During a TIPS procedure an Interventional Radiologist uses imaging techniques to tunnel through the liver to connect the portal vein to one of the hepatic veins.  The tunnel is kept open by inserting a metal stent into the tract.

How is the Procedure Performed? 

At Tufts Medical Center TIPS procedures are performed by a specially trained radiologist in the Interventional Radiology department. On the day of the procedure you will come in from home and will stay overnight for observation after the procedure is completed. In the CVC Suite you will be prepared for the procedure.  The procedure is typically performed under general anesthesia; you will be asleep for the entire procedure.  Once you are positioned on the procedure table and anesthetized your neck will then be cleansed and sterilized.  Your physician will then numb the skin and make a small nick in the skin where the catheter will be inserted into your vein.  The physician will use X-ray to guide the catheter to toward the liver.  Several pressure measurements are obtained to confirm the presence of portal hypertension and its severity.  Using a special needle, a tunnel is created connecting the portal vein to one of the hepatic veins.  A specially designed stent is then inserted to keep the tract open.  Once your physician has completed the procedure the catheter will be removed and a dressing is applied to the neck.

What Should I Expect After the Procedure?

At the completion of the procedure you will be monitored in an in-patient unit overnight.  You may experience some discomfort after the procedure which will be controlled with pain medications given to you through either your intravenous or by mouth.    It is expected that you will be able to return to normal activity within a few days after your TIPS procedure.  Frequent ultrasounds are performed to monitor the TIPS and are performed on a outpatient basis.

What are the Risks of a TIPS procedure?

• Infection
• Bleeding
• Heart Failure
• Arrhythmias
• Temporary alteration in normal brain function
• Temporary changes in liver function