North American Practice-Based Recommendations for Transjugular Intrahepatic Portosystemic Shunts in Portal...

Area of Science:

• Hepatology and Interventional Radiology
• Gastroenterology
• Liver Disease Management

Background:

• Complications of portal hypertension, such as ascites and bleeding, lead to high morbidity and mortality.
• Transjugular intrahepatic portosystemic shunt (TIPS) creation is a key intervention for managing these complications.
• Varied practices and knowledge gaps exist regarding TIPS, necessitating updated guidelines.

Purpose of the Study:

• To critically review the application of TIPS in managing portal hypertension.
• To develop practice-based recommendations for candidate selection, procedural best practices, and post-TIPS management.
• To establish consensus on TIPS indications and complication prevention.

Main Methods:

• A multidisciplinary group of North American experts convened to review existing literature.
• Expert consensus was formed through critical review of current practices and research.
• Recommendations were developed for the use of TIPS in patients with portal hypertension.

Main Results:

• New procedural techniques, stent technologies, and indications for TIPS have emerged.
• Practices and outcomes for TIPS vary significantly across institutions.
• Identified knowledge gaps and areas for future research in TIPS application.

Conclusions:

• A multidisciplinary approach and technical expertise are crucial for successful TIPS outcomes.
• Updated recommendations are needed for candidate selection, procedural best practices, and post-TIPS management.
• Further research is required to optimize the use of TIPS in managing portal hypertension.