Treatments

Transjugular Intrahepatic Portosystemic Shunt (TIPS) is a minimally invasive procedure used to treat complications of portal hypertension, such as variceal bleeding, refractory ascites, and hepatic hydrothorax. The procedure involves accessing the internal jugular vein, advancing a catheter into the hepatic vein, and creating a tract through the liver tissue to connect the portal vein to the hepatic vein. A stent is then placed to maintain this channel, allowing blood to bypass the liver and reduce portal venous pressure. TIPS is particularly useful for patients who do not respond to medications or endoscopic treatments. Benefits include effective control of variceal bleeding, reduction of ascites, and improvement in portal hypertension-related symptoms. Risks may include hepatic encephalopathy, stent occlusion or stenosis, bleeding, infection, and, rarely, liver failure. The procedure is performed under imaging guidance, usually fluoroscopy, to ensure precise placement of the shunt and minimize complications.

• Access route: Internal jugular vein → hepatic vein → portal vein.
• Purpose: Manage complications of portal hypertension (bleeding, ascites, hydrothorax).
• Procedure: Catheterization → hepatic-portal tract creation → stent placement.
• Imaging: Fluoroscopy (and sometimes ultrasound) guidance used.
• Benefits: Controls variceal bleeding, reduces ascites, improves portal hypertension.
• Risks: Hepatic encephalopathy, stent stenosis/occlusion, bleeding, infection, rare liver failure.