Transjugular Intrahepatic Portosystemic Shunt (TIPS) and Portal Hypertension

Chronic liver disease results in approximately 38,000 deaths a year, making it the 12th leading cause of mortality in the United States. Progressive liver disease results in portal hypertension, which leads to sequelae such as ascites, variceal hemorrhage, hepatic hydrothorax, and hepatorenal syndrome. Management includes screening for esophageal varices and treating complications of portal hypertension with medical, endoscopic, and interventional therapies. The transjugular intrahepatic portosystemic shunt (TIPS) has been proven effective in treating variceal hemorrhage, refractory ascites, and other manifestations of portal hypertension. Clinical indications, patient selection, technical considerations, post-procedure management, and complications are discussed in this chapter.