TIPS stands for transjugular intrahepatic portosystemic shunt. Patients who need this procedure have cirrhosis, where the portal vein that transports blood from the intestine to the liver becomes abnormally high in pressure (portal hypertension), which leads to varicose veins and bleeding problems in the abdomen. Cirrhosis with portal hypertension can also lead to fluid build-up on the abdomen (ascites).
At South Florida Vascular Associates, we can use the TIPS procedure to establish a shunt that will open the portal vein and divert the high pressure flow to a low pressure area and resolve portal hypertension with bleeding or ascites.
This procedure used to be done with open surgery; it was called a portosystemic shunt. It was a very dangerous surgery, as it was fatal about half the time. Now, our doctors can do a much safer minimally invasive procedure that accomplishes the same thing.
With the patient lying on his or her back, the doctor numbs the area where the jugular vein is. Under X-ray guidance, the doctor threads little catheters from the jugular vein into the liver. He puts a needle in the liver to make a connection between the low pressure hepatic vein, which drains into the heart, and the high pressure portal vein, which drains into the liver.
Once that connection is established, the doctor uses angioplasty to place a stent (a tubular metal scaffolding) inside the liver to keep the portal vein open, which allows the blood to shunt right through the liver into the hepatic vein. This reduces pressure in the portal vein and stops the bleeding. Fluid build-up on the abdomen usually goes away or is reduced.
While TIPS can effectively treat the symptoms of cirrhosis – bleeding and fluid build-up – it does not do anything to improve liver function.