Transjugular intrahepatic portosystemic shunts (TIPS)

Patrick Sequeira Kamath, Michael A. Mckusick

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure recently introduced for the management of complications of portal hypertension. TIPS can be-placed in the liver with relative ease by a skilled radiologist with a low risk of mortality. The major complications following the procedure are infection, especially in patients undergoing emergency TIPS, intra-abdominal haemorrhage from capsular punctures, and long-term problems related to encephalopathy and stenosis of the shunt. Encephalopathy is more of a problem in older patients with wide diameter shunts. Stenosis of the shunt is related to pseudo-intimal hyperplasia, probably related to transection of bile ductules during placement of the shunt. In view of the high rate of encephalopathy and stenosis following the shunt, a careful follow-up of all patients, including ultrasonographic and angiographic examination of the shunt, is mandatory. TIPS is used predominantly for the control of acute variceal haemorrhage, prevention of recurrent variceal bleeding, and refractory ascites when conventional treatment has failed. However, the role of TIPS in the management of complications of portal hypertension still awaits the outcome of clinical trials.

Original languageEnglish (US)
Pages (from-to)327-349
Number of pages23
JournalBailliere's Clinical Gastroenterology
Volume11
Issue number2
DOIs
StatePublished - Jun 1997

Fingerprint

Transjugular Intrahepatic Portasystemic Shunt
Brain Diseases
Pathologic Constriction
Portal Hypertension
Hemorrhage
Tunica Intima
Punctures
Ascites
Bile
Hyperplasia
Emergencies
Clinical Trials
Mortality
Liver
Infection

Keywords

  • Ascites
  • Portal hypertension
  • Portosystemic shunts
  • Variceal haemorrhage

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Transjugular intrahepatic portosystemic shunts (TIPS). / Kamath, Patrick Sequeira; Mckusick, Michael A.

In: Bailliere's Clinical Gastroenterology, Vol. 11, No. 2, 06.1997, p. 327-349.

Research output: Contribution to journalArticle

@article{435bbc9af06346c2af6be43b928ed360,
title = "Transjugular intrahepatic portosystemic shunts (TIPS)",
abstract = "Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure recently introduced for the management of complications of portal hypertension. TIPS can be-placed in the liver with relative ease by a skilled radiologist with a low risk of mortality. The major complications following the procedure are infection, especially in patients undergoing emergency TIPS, intra-abdominal haemorrhage from capsular punctures, and long-term problems related to encephalopathy and stenosis of the shunt. Encephalopathy is more of a problem in older patients with wide diameter shunts. Stenosis of the shunt is related to pseudo-intimal hyperplasia, probably related to transection of bile ductules during placement of the shunt. In view of the high rate of encephalopathy and stenosis following the shunt, a careful follow-up of all patients, including ultrasonographic and angiographic examination of the shunt, is mandatory. TIPS is used predominantly for the control of acute variceal haemorrhage, prevention of recurrent variceal bleeding, and refractory ascites when conventional treatment has failed. However, the role of TIPS in the management of complications of portal hypertension still awaits the outcome of clinical trials.",
keywords = "Ascites, Portal hypertension, Portosystemic shunts, Variceal haemorrhage",
author = "Kamath, {Patrick Sequeira} and Mckusick, {Michael A.}",
year = "1997",
month = "6",
doi = "10.1016/S0950-3528(97)90043-9",
language = "English (US)",
volume = "11",
pages = "327--349",
journal = "Bailliere's Clinical Gastroenterology",
issn = "0950-3528",
publisher = "Bailliere Tindall Ltd",
number = "2",

}

TY - JOUR

T1 - Transjugular intrahepatic portosystemic shunts (TIPS)

AU - Kamath, Patrick Sequeira

AU - Mckusick, Michael A.

PY - 1997/6

Y1 - 1997/6

N2 - Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure recently introduced for the management of complications of portal hypertension. TIPS can be-placed in the liver with relative ease by a skilled radiologist with a low risk of mortality. The major complications following the procedure are infection, especially in patients undergoing emergency TIPS, intra-abdominal haemorrhage from capsular punctures, and long-term problems related to encephalopathy and stenosis of the shunt. Encephalopathy is more of a problem in older patients with wide diameter shunts. Stenosis of the shunt is related to pseudo-intimal hyperplasia, probably related to transection of bile ductules during placement of the shunt. In view of the high rate of encephalopathy and stenosis following the shunt, a careful follow-up of all patients, including ultrasonographic and angiographic examination of the shunt, is mandatory. TIPS is used predominantly for the control of acute variceal haemorrhage, prevention of recurrent variceal bleeding, and refractory ascites when conventional treatment has failed. However, the role of TIPS in the management of complications of portal hypertension still awaits the outcome of clinical trials.

AB - Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure recently introduced for the management of complications of portal hypertension. TIPS can be-placed in the liver with relative ease by a skilled radiologist with a low risk of mortality. The major complications following the procedure are infection, especially in patients undergoing emergency TIPS, intra-abdominal haemorrhage from capsular punctures, and long-term problems related to encephalopathy and stenosis of the shunt. Encephalopathy is more of a problem in older patients with wide diameter shunts. Stenosis of the shunt is related to pseudo-intimal hyperplasia, probably related to transection of bile ductules during placement of the shunt. In view of the high rate of encephalopathy and stenosis following the shunt, a careful follow-up of all patients, including ultrasonographic and angiographic examination of the shunt, is mandatory. TIPS is used predominantly for the control of acute variceal haemorrhage, prevention of recurrent variceal bleeding, and refractory ascites when conventional treatment has failed. However, the role of TIPS in the management of complications of portal hypertension still awaits the outcome of clinical trials.

KW - Ascites

KW - Portal hypertension

KW - Portosystemic shunts

KW - Variceal haemorrhage

UR - http://www.scopus.com/inward/record.url?scp=0030781021&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030781021&partnerID=8YFLogxK

U2 - 10.1016/S0950-3528(97)90043-9

DO - 10.1016/S0950-3528(97)90043-9

M3 - Article

C2 - 9395751

AN - SCOPUS:0030781021

VL - 11

SP - 327

EP - 349

JO - Bailliere's Clinical Gastroenterology

JF - Bailliere's Clinical Gastroenterology

SN - 0950-3528

IS - 2

ER -