Transjugular Intrahepatic Portosystemic Shunt (or TIPS) is a procedure to place a small tube between the portal vein of the liver and the hepatic vein. It is used to treat portal hypertension, a condition that develops when cirrhosis of the liver causes a blockage in the portal vein.
The portal vein is the blood vessel responsible for transporting blood from your gastrointestinal tract, spleen, gallbladder and pancreas to your liver. The liver processes this nutrient-rich blood, extracting nutrients and filtering out toxins. Nearly 75 percent of the liver’s total blood flow comes through the portal vein, with the remainder flowing through the hepatic vein. The hepatic vein carries blood from the liver to the heart.
Portal hypertension occurs when the blood flow through the portal vein is blocked, usually by excessive scar tissue from cirrhosis. When this blockage occurs, the blood in the portal vein changes course, and begins to flow into smaller vessels across your esophagus and abdomen. These smaller vessels aren’t used to a large volume of blood, so they stretch to accommodate it, becoming enlarged veins known as varices. Because the veins are abnormally stretched, they become fragile and are prone to rupturing, causing abdominal or esophageal bleeding. In addition, when the blood is no longer flowing through the liver for filtering, other organs (such as the kidneys) are unable to effectively eliminate excess sodium, resulting in fluid retention in the abdomen (ascites).
A transjugular intrahepatic portosystemic shunt (TIPS) is an artificial path created in the liver using a small metal device known as a stent. The stent connects the two primary veins of the liver, the portal and hepatic veins. By keeping the connection open between the portal and hepatic vein, it allows blood from the gastrointestinal system to bypass the liver, which reduces pressure in the portal vein and prevents blood from re-routing itself to smaller vessels and creating varices. This procedure can successfully reduce the risk of abdominal and esophageal bleeding as a result of ruptured variceal veins in people with cirrhosis. It can also be utilized to treat the following conditions:
The TIPS procedure is minimally invasive, and usually performed using general anesthesia or local anesthesia with IV sedation. Your interventional radiologist will make a small incision near your jugular vein (right above your collarbone) and insert a narrow catheter into the vein. Using x-ray guidance, the interventional radiologist will thread the catheter through the jugular vein, toward the liver and into the hepatic vein. They will then measure the blood pressure in the hepatic vein to determine the severity of portal hypertension, while confirming that it is the correct diagnosis.
Contrast dye is injected into the hepatic vein so that your doctor can better identify your portal venous system, and a stent is placed, opening a path from the portal vein to the hepatic vein. Once the stent has been placed, the catheter is removed, and your blood pressure in the portal vein is measured again, to confirm that the stent reduced the pressure. Portal venograms are performed as well to ensure that blood is flowing correctly through the TIPS.
The procedure itself typically takes no longer than one or two hours, but this depends on your specific vascular anatomy and the severity of your condition.
After the TIPS procedure, a bandage is applied to the incision – no sutures necessary – and you will keep your head elevated for a few hours. You will be closely monitored at the hospital overnight to ensure that any bleeding is controlled before you are allowed to return home. You should be able to get back to your normal routine within about seven to ten days, and you will have regular follow-up appointments to make sure that the TIPS stent is continuing to function properly.
Because TIPS surgery is minimally invasive, the risks that come with open surgery are greatly reduced. Recovery time is shorter, and studies show that variceal bleeding is reduced in more than 90 percent of patients following the procedure. If you require an open surgical bypass or liver transplantation in the future, using a TIPS will ensure that there is no scar tissue in the abdomen, and since the stent used is contained in your liver, it is removed along with it during a transplant.
Like any medical procedure TIPS surgery carries some minor risks, including:
More serious complications (which happen in less than five percent of patients) include:
Again, these are extremely rare occurrences, and every precaution is taken to mitigate possible risks. At your initial consultation, your vascular and interventional radiologist will perform a physical examination and review your medical history to determine if the TIPS procedure is right for you. You will need to let them know about all medications you are taking, including over-the-counter and herbal supplements, to help ensure that you will not experience any interactions with materials used in the surgery.
If you suffer from complications of portal hypertension, it may be time to explore a Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure. Call IVC today at 503-612-0498 and schedule an appointment for a consultation.
* This information about Transjugular Intrahepatic Portosystemic Shunt was reviewed by Dr. Jason R. Bauer. If you have any questions, please don’t hesitate to contact us using the form below.
Dr Jason Bauer performed our 20 year old son’s kidney biopsy last week. I have had a lot of experience with medical care. Dr Bauer has moved to the top five of all doctors we have encountered. He has taught us more about our son’s medical condition than any other doctor has since March 2019! I just kept wanting to ask him more questions 😄. I felt super confident that our son was getting the best care he could when I let him go into the procedure. Dr Bauer’s skill, knowledge and ability to translate it into lay peoples terms far exceeded FIVE STARS and our expectations. He also related to our young adult son well which put him at ease.
A.R.Wonderful nurse, did a good job. I am thrilled and excited. (EVLT Patient)
C.W.If I have to have another drain ever I will come to IVC. Everyone is so great there.
P.P.Your office has done a great job at follow up.
E.M.You all are so nice. Thank you for being there. Your facility is so great. So happy not to have to go to the hospital for this.
P.A.You all were wonderful. My experience started with the pre-procedure call – where comfort, trust and confidence was gained. Mary Anne is an asset. Thanks to Vicky, Paul and Dr. Pfister for their true care & concern.
M.I.Thank you all, the team was great to work with. I appreciate your care.
C.D.Your team is exemplary. This leads to outstanding results. Thank you for being great!
I.S.Everyone at the oncology clinic said how great the port looked today!
S.V.M.Thank you for the time you spent with me today on the phone. You made a big difference. More than I can express. You have given me hope, calmed my anxiety and informed me. I was getting confused by all of the different instructions and restrictions by others.
R.M.You made this painless. Your team works together well. Thank you. I feel better already!
M.R.Best doctors in town! Dr. Zhang speaks fluent Mandarin which was very helpful to my uncle!
A.C.You guys were so AWESOME! Thank you for making this scary procedure go smooth and making me comfortable. You all are great.
C.P.I am a medical oncologist who has been referring my patients to the physicians at IVC for 8 years now. In my career, I have never worked with a more dedicated, thorough, humane, and technically superb group of physicians. I have received countless words of positive feedback from my patients echoing the above sentiments.
More recently, I have been a patient with Dr. Michael Pfister. Dr. Pfister is an outstanding interventionalist, who brings a warm bedside manner to his interactions. He is the “whole package,” providing both technical savvy as well as kindness. As a patient, I could not ask for more.
I.S.I’ve been a pt of Dr. Pfisters for over 10yrs, during which time he has performed 5+ procedures. As a medical professional myself, I have an exceptionally high expectation of the quality of care I receive, as well…and JUST AS IMPORTANT…the attitude and respect my Dr’s and healthcare team provide! Dr. Pfister and the staff on his team get AA+++ from me!!!!! He is kind, respectful, informative AND an EXCEPTIONALLY skilled interventional radiologist!!! I won’t EVER trust anyone else!!!
P.R.From the time I first spoke to Maryanne who was so kind, and walked thru your doors with friendly smiles to greet me – meeting Patty who was so kind and caring and meeting Dr. Love – great bedside manner and smile and made sure all my questions were answered – and having the port placed with an excellent team – Paul asking me what my hobbies were first thing – I knew I was in the right place! Thank you all, you all are amazing!
AnonymousOne of our best medical experiences during our entire cancer treatment. Thanks so much for everything!
AnonymousThis is for Dr. Pfister. I just wanted to thank him for all the time he spent with us the other week. In all the years I’ve had my vascular problems I’ve never had a doctor really sit down and explain to me the intricacies of what might be going on. I have a lot to think about…but just wanted to say thanks for being so nice and answering our many questions!
L.H.A fantastic group of wonderful people. The procedure was very smooth. When they were putting the port in I felt like I was getting a great massage!! Thank you all!
S.C.Charley was instrumental in getting me scheduled in quickly to get my PICC line removed. She actually worked until late in the day to get the information from my referring doctor’s office. It is nice to know great people like Charley still exist in this world!
K.S.I had my blood clot filter removed on 2/21/18. I was very apprehensive, yet EVERYONE in Dr. Pfister’s office and surgical team helped to make me comfortable. I am extremely claustrophobic so laying down or having something covering my face creates anxiety. Mary Anne listened to my concerns and made sure I was made comfortable and did not feel anxious. The surgical team was amazing, they explained everything thoroughly. Dr. Pfister came in after the procedure to review what he did and discuss any follow up that might be required. I so appreciate the time and attention he gives me as his patient. This was a positive experience.
G.H.110% Thank You! Best unit so far in my cancer treatment. Thanks Dr. Love
AnonymousIf you ever need an Interventional Radiologist for a child I realize it is serious business. I’ve seen Dr. Love go and save a child’s kidney without missing a beat. I could recommend no one better for myself, or for people I love. I think he is a little cool at the bedside, but that’s OK Dr. Love, stay frosty! If you can’t see Dr. Love, one of the other professionals at IVC will be able to help you. Ashley, the dynamite scheduler and one of the other surgeons at IVC will care for you. I’ve had multiple surgeries with this practice over the past several years. Never a hiccup!
S. R. – Portland, ORGreat experience, doctor was thorough in explaining what was going to happen. The nurses were very attentive and made sure I was comfortable and my needs were met. I would recommend this office for any related procedure.
AnonymousEverything went very smoothly. Joe enjoyed the music. Very friendly staff! Good Experience!
J. & E.All staff was courteous and efficient. Good experience.
J. J.Dr. Pfister, thanks so much for your excellent care, removing my chemo port earlier this week. With all your experience and your fine touch, I’m confident the scar will be nearly invisible. Your team, from beginning to end, did a super job with me. Please extend my gratitude to Jennifer, Mary Anne, Todd and Charley. I’ve got a whole lot of living left to do. I appreciate all of you helping me do it!
M. F.Dr. Pfister, thank you for all of the attention you gave to me. I learned lots from our discussion – hearing you speak of ultimate healing was enough to encourage me to do all I can to strengthen those muscles.
S. O.The entire office is one of the most professional, helpful and informative medical offices I have dealt with (and I have dealt with many). Kudos to Jennifer, Henry, and Charley!
K. C.Great people. Great place. Good surgery.
G. G.Patty, Mary Anne and the whole staff was amazing! Best experience I’ve had since being diagnosed with cancer. From start to finish, was great. Thanks.
MMy brother came into Legacy Meridian Park, had a stroke. Dr. Bauer came in immediately, in his work jeans and shirt. He worked with Neurologist Dr. Burbank, developed a plan and took my brother into a procedure where they removed the clot from his head! Very down to earth doctor, explained procedure to family, worked with sense of urgency.
J. P.I want to comment regarding Dr. Bauer of how he was thorough explaining my CT Biopsy and showing me how on the computer he would get the tissue needed. In all the years of several surgeries I have never felt better going in to have a procedure done. His bedside manner was incredible. I wish all doctors were like Dr. Bauer. Thank you for preparing and relaxing me prior to the biopsy.
R.S. Molalla OREveryone did a superb job taking care of me and doing the procedure. Thank You All
K.S.Dr. Bauer genuinely cares about his patients and strives to make sure they understand every aspect of their treatment.
A.L.Dr. Bauer, our family wants you to know how thankful we are to you for saving G.P.’s life and bringing him back to us in normal health. Thank you over and over you are the best!
Family of G. P.
We are announcing that Interventional and Vascular Consultants will be closing as of March 10, 2023.
We would like to thank you for the trust you have given us over the years, participating in your healthcare needs has been a privilege.
To assist in a smooth transition to a new provider, you may access your records from your MyHealth account or request a copy of medical records by clicking the link below and completing the Release of Information form.
Please know that we have greatly valued our relationship with you and wish you the best.
Sincerely,
Jason Bauer, MD RVT
Michael Pfister, MD RVT
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