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Transjugular Intrahepatic Portosystemic Shunt in Radiology

Overview

A transjugular intrahepatic portosystemic shunt (TIPS) is a percutaneously created connection within the liver between the portal and systemic circulations. A TIPS is placed to reduce portal pressure in patients with complications related to portal hypertension.
This procedure has emerged as a less invasive alternative to surgery in patients with end-stage liver disease.
See the images below.

Basic transjugular intrahepatic portosystemic shun

Basic transjugular intrahepatic portosystemic shunt (TIPS) procedure. A curved catheter is placed into the right hepatic vein.

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Basic transjugular intrahepatic portosystemic shun

Basic transjugular intrahepatic portosystemic shunt (TIPS) procedure. Image demonstrates advancement of a Colapinto needle into the right portal vein.

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The goal of TIPS placement is to divert portal blood flow into the hepatic vein, so as to reduce the pressure gradient between portal and systemic circulations. Shunt patency is maintained by placing an expandable metal stent across the intrahepatic tract.

Transjugular intrahepatic portosystemic shunt implantation is an effective and safe treatment for portal hypertension in patients with hepatocellular carcinoma, according to one study. Portal hypertension and hepatocellular carcinoma (HCC) are major complications of advanced liver cirrhosis. Forty HCC patients with portal hypertension who were treated with TIPS between 1995 and 2012 were included in the analysis. There were no severe procedure-related complications, and no deterioration of liver function was observed.

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