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Transjugular Intrahepatic
Portosystemic Shunt (TIPS)



A&I Protocol





[Left] Angiogram showing access into the portal venous system via transjugular approach and into the hepatic portal venous system via a percutaneous liver approach. [Right] Pre-dilatation of the tract from portal venous system to hepatic portal venous system.

Angiogram of the hepatic and portal venous system in the liver. A pigtail catheter is positioned to measure the length of stent required to bridge the portal venous and hepatic portal venous systems.

Final angiogram showing the stent placement (following post-dilatation), forming the intrahepatic portosystemic shunt.
References
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Vizzutti F, Schepis F, Arena U, Fanelli F, Gitto S, Aspite S, et al. Transjugular intrahepatic portosystemic shunt (TIPS): current indications and strategies to improve the outcomes. Intern Emerg Med. 2020 Jan;15(1):37–48.
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Tripathi D, Stanley AJ, Hayes PC, Travis S, Armstrong MJ, Tsochatzis EA, et al. Transjugular intrahepatic portosystemic stent-shunt in the management of portal hypertension. Gut. 2020 Jul;69(7):1173–92.
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Strunk H, Marinova M. Transjugular Intrahepatic Portosystemic Shunt (TIPS): Pathophysiologic Basics, Actual Indications and Results with Review of the Literature. Rofo. 2018 Aug;190(8):701–11.
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Lee HL, Lee SW. The role of transjugular intrahepatic portosystemic shunt in patients with portal hypertension: Advantages and pitfalls. Clin Mol Hepatol. 2022 Apr;28(2):121–34.
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Keller FS, Farsad K, Rösch J. The Transjugular Intrahepatic Portosystemic Shunt: Technique and Instruments. Tech Vasc Interv Radiol. 2016 Mar;19(1):2–9.