Comprehensive review of TIPS technical complications and how to avoid them

Area of Science:

• Interventional Radiology
• Hepatology
• Vascular Surgery

Background:

• Portal hypertension complications necessitate advanced treatments.
• Transjugular intrahepatic portosystemic shunts (TIPS) are an established therapy.
• Despite efficacy, TIPS placement carries inherent risks.

Purpose of the Study:

• To detail technical complications associated with TIPS placement.
• To outline strategies for preventing and managing these complications.
• To enhance the safety and success of the TIPS procedure.

Main Methods:

• Review of technical aspects of TIPS insertion.
• Analysis of potential pitfalls during venous access, imaging, and puncture.
• Discussion of challenges in shunt deployment and embolization.

Main Results:

• TIPS placement involves complex steps with potential for methodologic errors.
• Morbidity rates directly related to the TIPS procedure can be as high as 20%.
• Complications can occur at any phase, from access to embolization.

Conclusions:

• Interventional radiologists must possess a comprehensive understanding of TIPS procedures.
• Knowledge of potential adverse events and technical nuances is vital.
• Mastery of TIPS insertion techniques minimizes procedural risks and improves outcomes.