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Transjugular Intrahepatic Portosystemic Shunt: An Update.
Masayoshi Yamamoto1, Kentaro Yamada1, Mitsuhiro Kinoshita1
1Department of Radiology, Teikyo University School of Medicine, Japan.
Interventional Radiology (Higashimatsuyama-Shi (Japan)
|November 19, 2024
Summary
Transjugular intrahepatic portosystemic shunt (TIPS) is a less invasive procedure for portal hypertension complications. While improved stents reduce dysfunction, hepatic encephalopathy and liver failure remain key concerns after TIPS for cirrhosis patients.
Area of Science:
- Interventional Radiology
- Hepatology
- Gastroenterology
Background:
- Transjugular intrahepatic portosystemic shunt (TIPS) introduced over 50 years ago.
- TIPS is a less invasive alternative to surgery for managing portal hypertension complications like refractory variceal bleeding and ascites.
- Early TIPS procedures faced challenges with stent patency and hepatic encephalopathy.
Purpose of the Study:
- To review the current literature on the status and efficacy of TIPS in treating cirrhosis.
- To discuss the evolution of TIPS procedures and their associated complications.
- To highlight ongoing challenges and advancements in TIPS therapy for liver disease.
Main Methods:
- Comprehensive review of existing scientific literature on TIPS.
- Analysis of historical and recent data concerning TIPS outcomes and complications.
- Evaluation of technological advancements, such as covered stents, in TIPS procedures.
Main Results:
- TIPS is widely adopted due to its minimally invasive nature compared to surgical options.
- Modern covered stents have improved long-term shunt patency.
- Hepatic encephalopathy and early liver failure persist as significant post-TIPS complications.
Conclusions:
- TIPS remains a critical intervention for managing complications of portal hypertension in cirrhosis.
- Continued research is needed to mitigate risks like hepatic encephalopathy and liver failure post-TIPS.
- Advancements in stent technology offer promise but do not eliminate all major post-TIPS complications.
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