Transjugular Intrahepatic Portosystemic Shunt

What is a transjugular intrahepatic portosystemic shunt?

Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure done to improve blood flow to and from the liver. With TIPS, a needle is inserted through a vein in your neck to place a small tube called a stent between your portal vein and one of your hepatic veins. The portal vein carries blood from your intestines to your liver. The hepatic veins bring blood from your liver back to your heart.

When is it used?

Normally, blood coming from your esophagus, stomach, and intestines flows through the liver. Liver disease and scarring can block blood flow and increase pressure in the portal vein. This is called portal hypertension. Portal hypertension may be caused by:

  • Alcohol abuse
  • Too much iron in the liver
  • Liver infections such as hepatitis B or hepatitis C

High blood pressure in the portal vein causes blood to move backward. This backwards flow of blood makes the veins swell, and fluid collects in your chest and belly. The increased pressure can cause bleeding of swollen veins in your esophagus.

The shunt reduces pressure in your veins and helps blood to flow from your intestines, through your liver, and back to your heart. This helps the veins shrink back to normal size and can help stop or prevent fluid buildup in your chest and belly.

How do I prepare for this procedure?

  • Plan for your care and find someone to give you a ride home after the procedure.
  • Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
  • Tell your provider if you have had kidney problems or an allergy to chemicals, such as contrast dye. Contrast dye is used for some scans.
  • Follow your healthcare provider’s instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It is best to quit 6 to 8 weeks before surgery.
  • Some medicines (like aspirin or blood thinners such as Coumadin) may increase your risk of bleeding during or after the procedure. You may or may not need to take your regular medicines the day of the procedure, depending on what they are and when you need to take them. Tell your healthcare provider about all medicines and supplements that you take. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
  • Follow any other instructions your healthcare provider gives you.
  • Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for tests or procedures.

What happens during this procedure?

You will be given local or general anesthesia to keep you from feeling pain during the procedure. Local anesthesia numbs the area where the needle will be inserted in your neck. You may also be given a sedative to help you relax but you may be awake during the procedure. General anesthesia relaxes your muscles and you will be asleep.

A radiologist will put a flexible tube called a catheter into a vein in your neck, through a needle. Using contrast dye and special X-rays, your provider will guide the catheter into a vein in your liver. He will connect the portal vein to one of your hepatic veins, using a stent to keep the connection open.

The procedure takes 1 to 3 hours.

What happens after this procedure?

You will stay in the hospital for at least 1 to 2 days. Follow your healthcare provider’s advice about diet when you go home.

Ask your healthcare provider:

  • How and when you will hear your test results
  • How long it will take to recover
  • What activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

What are the risks of this procedure?

Your healthcare provider will explain the procedure and any risks. Some possible risks include:

  • Anesthesia has some risks. Discuss these risks with your healthcare provider.
  • You may have infection, bleeding, or blood clots.
  • You may have an allergic reaction to the dye.
  • There is a risk of bleeding and damage to blood vessels.
  • The shunt may narrow or get blocked, and you may need another procedure.
  • Encephalopathy, which often happens with severe liver disease, may get worse. This condition may cause memory problems, confusion, seizures, and coma.

There is risk with every treatment or procedure. Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.

Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth.
Last modified: 2014-02-20
Last reviewed: 2014-12-22
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

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