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Background and Objectives <p>The transjugular intrahepatic portosystemic shunt (TIPS) was invented and clinically implemented around 30&#xa0;years ago.</p> Methods <p>In all, 101 consecutive patients treated with TIPS at Ordensklinikum Linz between 2013 and 2018 were retrospectively analyzed.</p> Results <p>The most common indication was refractory ascites (48%). In 73% of these cases, ascites control was observed postimplantation, although a&#xa0;majority (56%) still required diuretics. The volume of ascites was significantly reduced by the implantation (54% vs.&#xa0;20%). Freedom from recurrent bleeding was achieved in 72% of cases. A&#xa0;30-day mortality rate of 5% and an overall mortality rate of 28% were observed. The most frequent postinterventional complication was hepatic encephalopathy (HE), occurring in 28% of cases a&#xa0;few weeks after implantation and in 20% at the last follow-up appointment. Liver transplantation was performed in 8% of patients, and 18% were diagnosed with hepatocellular carcinoma (HCC). Body mass index (BMI) and laboratory values showed only minor fluctuations. Following implantation, 84% of patients were prescribed antiplatelet therapy. The model of end stage liver disease (MELD) score increased after implantation (mean 12 vs.&#xa0;13) but stabilized by the last follow-up.</p> Conclusion <p>TIPS implantation is safe and, in most cases, results in ascites control or freedom from bleeding. The most common complication is HE, which can usually be effectively managed with medication.</p>

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Indikationen, Durchführung, Ergebnisse und Komplikationen eines transjugulären portosystemischen Shunts (TIPS)

  • 期刊论文

  • 发表日期：

    2025年6月11日

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  • Ferdinand Bittner,
  • Thomas Altmann,
  • Michael Weitersberger,
  • Sabrina Hettegger,
  • Alexander Ziachehabi,
  • Rainer Schöfl

摘要

Background and Objectives

The transjugular intrahepatic portosystemic shunt (TIPS) was invented and clinically implemented around 30 years ago.

Methods

In all, 101 consecutive patients treated with TIPS at Ordensklinikum Linz between 2013 and 2018 were retrospectively analyzed.

Results

The most common indication was refractory ascites (48%). In 73% of these cases, ascites control was observed postimplantation, although a majority (56%) still required diuretics. The volume of ascites was significantly reduced by the implantation (54% vs. 20%). Freedom from recurrent bleeding was achieved in 72% of cases. A 30-day mortality rate of 5% and an overall mortality rate of 28% were observed. The most frequent postinterventional complication was hepatic encephalopathy (HE), occurring in 28% of cases a few weeks after implantation and in 20% at the last follow-up appointment. Liver transplantation was performed in 8% of patients, and 18% were diagnosed with hepatocellular carcinoma (HCC). Body mass index (BMI) and laboratory values showed only minor fluctuations. Following implantation, 84% of patients were prescribed antiplatelet therapy. The model of end stage liver disease (MELD) score increased after implantation (mean 12 vs. 13) but stabilized by the last follow-up.

Conclusion

TIPS implantation is safe and, in most cases, results in ascites control or freedom from bleeding. The most common complication is HE, which can usually be effectively managed with medication.