The transjugular intrahepatic portosystemic shunt: an update

• Published in: American journal of roentgenology (1976) Vol. 199; no. 4; pp. 746 - 755
• Main Authors: Fidelman, Nicholas, Kwan, Sharon W, LaBerge, Jeanne M, Gordon, Roy L, Ring, Ernest J, Kerlan, Jr, Robert K
• Format: Journal Article
• Language: English
• Published: United States 01.10.2012
• Subjects: Ascites - surgery; Budd-Chiari Syndrome - surgery; Contraindications; Esophageal and Gastric Varices - complications; Esophageal and Gastric Varices - surgery; Gastrointestinal Hemorrhage - etiology; Gastrointestinal Hemorrhage - prevention & control; Humans; Hydrothorax - etiology; Hydrothorax - surgery; Hypertension, Portal - complications; Hypertension, Portal - diagnosis; Hypertension, Portal - physiopathology; Hypertension, Portal - surgery; Patient Selection; Portasystemic Shunt, Transjugular Intrahepatic - adverse effects; Portasystemic Shunt, Transjugular Intrahepatic - methods
• ISSN: 0361-803X; 1546-3141
• DOI: 10.2214/ajr.12.9101

The purpose of this article is to review the indications, outcomes, complications, patient selection, and technical aspects of creating a transjugular intrahepatic portosystemic shunt (TIPS). The best available evidence supports the use of TIPS in secondary prevention of variceal bleeding and in refractory ascites, although TIPS is also commonly used for other indications such as Budd-Chiari syndrome, hepatic hydrothorax, and acute variceal hemorrhage. The TIPS procedure was revolutionized by the introduction of covered stents, which dramatically improved long-term shunt patency.