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TIPS – Transjugular Intrahepatic Portosystemic Shunt

What is TIPS?

Transjugular intrahepatic portosystemic shunt (TIPS) is a non-surgical procedure to create new connections between two blood vessels in the liver.  At South Florida Vascular Associates, we can use the TIPS procedure to establish a shunt that will open the portal vein, divert the high-pressure flow to a low-pressure area, and resolve portal hypertension with bleeding or ascites.

Who is a Candidate for TIPS?

Patients who can benefit from the TIPS procedure have cirrhosis, where the portal vein that transports blood from the intestine to the liver becomes abnormally high in pressure (portal hypertension). This can lead to varicose veins and bleeding problems in the abdomen. Cirrhosis with portal hypertension can also lead to fluid build-up in the abdomen (ascites).

“Dr. Julien and his people are the most cohesive, personable and professional I’ve ever come across. From the time I walk in to when I leave I feel like they care about me. The result is good healing.”

– James R.

“Dr. Julien and his people are the most cohesive, personable and professional I’ve ever come across. From the time I walk in to when I leave I feel like they care about me. The result is good healing.”

– Josh R.

“Staff is awesome! Extremely knowledgeable & professional. They explained every step to me and spent plenty of time to answer my questions.”

– Anthony P.

“I was referred to Dr. W. Julian by my PCP and very happy that I was. Dr. Julian found a clogged artery that could have been life threatening if left untreated. My experience from consult to discharge was met courtesy, warmth and professionalism which helped me through my procedure. Sean greeted me and my son who explained the whole process and what to expect. I was also looked after by Josh, Jackie and Reuben who could not have been more supportive or communicative through this adventure.”

– Lorette K.

“The whole staff were very professional and very helpful in navigating me through every procedure, treatments and follow ups. I would certainly recommend South Florida Vascular Associates.”

– Don S.

“I have been very impressed by the way this office functions. Each and every person I’ve encountered has been very personable and professional. I’ve had minimal wait times before being seen. The tests I’ve had were done efficiently and results explained to me quickly. I would highly recommend this office.”

– Robert G.

“All of the staff were friendly, courteous, and professional. Examination and consultation were thorough and expedited in a timely manner. I felt relaxed throughout the visit and all my medical questions and concerns were met and answered to my satisfaction. Would recommend this office to anyone seeking vascular care.”

– Felix G.

“I highly recommend this office for any vascular procedure you may need. The staff are awesome. They were very considerate and professional. My procedures were all a success and I am very happy with the end result. Top marks on everything.”

– Todd H.

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The TIPS Procedure

In the past, this procedure was done with open surgery and was called a portosystemic shunt. Success rates with this procedure were poor, as it was fatal about half the time. Now, our doctors can perform a much safer minimally invasive procedure for optimal outcomes.

The TIPS procedure is performed on an outpatient basis by an interventional radiologist. During this procedure, you will lay on your back, and the doctor will numb the area where the jugular vein is. Under X-ray guidance, the doctor threads small 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 is important to note that it does not do anything to improve liver function.

TIPS Aftercare

Following your TIPs procedure, you will be able to return home. Most people can return to all normal activities within 7-10 days. Your doctor may recommend an ultrasound following the procedure to ensure that the shunt is working correctly.


William Julien, MD

Board-Certified Vascular Interventional Physician


Mana Khatkar, PA-C

Certified Physician Assistant


Anissa Rodriguez, NP-C

Certified Nurse Practitioner


Schedule a Consultation

To learn more about TIPS, contact our offices conveniently serving the greater Southeast Florida region. We’re located in Coconut Creek, Boynton Beach, and Plantation, FL, and provide advanced vascular and interventional oncology treatments performed on an outpatient basis.