TIPS (Trans-jugular Intrahepatic Portosystemic Shunt)

TIPS (Trans-jugular Intra-Hepatic Porto-systemic Shunt) is a complex procedure used to treat patients who develop acute or recurrent variceal bleeding, when other methods to control bleeding have failed including sclerotherapy. TIPS may beneficial to patients waiting to receive a liver transplant. It is also used to help control ascites that has not responded to previous treatment. The goal of the shunt placement is to reduce the pressure in the veins serving the bowel.

How do I prepare for the exam?

Do not eat or drink anything after midnight the night before the exam.

Most patients are admitted through the Admissions and Testing Unit about two hours prior to test time. After you check in, Admissions and Testing staff will prep you for your exam, including checking vital signs, taking any needed laboratory tests, and starting an IV if necessary.

If you are taking any blood thinners, diabetic medication or are allergic to contrast, please notify us when your exam is scheduled, as there are special instructions that go along with these conditions.

What can I expect during the exam?

The exam is conducted by an interventional radiologist, a specially trained interventional radiology technologist, anesthesia personnel and a nurse.

You will lie on your back on an exam table, and a nurse will place you on a monitor. General anesthesia will be administered.

An area on your neck will be sterilely cleaned and draped. Access to the liver is established through the jugular vein using a flexible catheter and a guidewire.

The radiologist will measure the pressure in your liver. Once a proper tract has been established, it will be dilated and a stent will be deployed into the tract. Pressures are again taken at this point. At the end of the procedure, the catheter will be removed and pressure will be applied to your neck until bleeding has stopped.

The procedure will take three to four hours.

What can I expect after the exam?

You will be admitted to Memorial for overnight observation. Follow up care and information will be provided by the radiologist or interventional radiology nurse.