What is a Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure?
Like all of the body’s organs, the liver needs a constant, healthy blood supply in order to function properly. In a healthy body, blood is channeled to the liver through the portal vein (which carries blood from the digestive organs to the liver) and away from the liver via heptic veins (which carry blood from the liver to the heart).
Some medical problems, including cirrhosis and conditions that cause blood clots, can impede blood flow through the portal vein. When this happens, blood pressure can rise to dangerous levels within the portal vein, a condition called portal hypertension. This can in turn cause dilation in other veins, called varices, within the stomach and esophagus. Excess pressure can also cause serious complications, including recurring fluid build-up in the chest or abdomen and internal bleeding. TIPS is a radiological procedure used to reduce pressure in the veins and restore healthy blood flow.
How is a TIPS procedure performed?
During a TIPS procedure, an interventional radiologist inserts a thin tube called a catheter into the body through a small incision in the neck. The physician guides the catheter to the liver using real-time X-ray and/or ultrasound guidance.
Next, the interventional radiologist guides a small needle through the catheter. This is used to create a new channel through the liver, connecting the portal vein to one of the heptic veins. This new pathway reduces the blood pressure in the portal vein and other affected veins. A small metal tube (stent) is placed inside the new pathway to hold it open over time.
What should I expect before, during, and after treatment?
Before you undergo the TIPS procedure, your interventional radiologist will talk with you about anything that you may need to do to prepare for the procedure. For instance, you may need to abstain from food or drink, or make changes to your medication schedule. You will have the opportunity to ask any questions you may have about the procedure.
During the procedure, you will be given anesthesia and will not experience any pain. The procedure typically takes about three hours, but you will stay in the hospital for one or more nights for observation. In the year following your TIPS procedure, your doctor will see you for several follow-up visits.