[TIPS dysfunction: what has to be done?]

Transjugular Intrahepatic Portosystemic Shunting (TIPS) is a minimally invasive interventional radiology procedure that demonstrates high efficacy in reducing the portocaval pressure gradient. However, despite the effectiveness of this technique, clinical practice reveals cases of shunt dysfunction manifesting as stenosis or thrombosis due to various causes (leakage of thrombogenic bile into the stent lumen, intimal hyperplasia, prolapse of loose liver tissue, etc.). This may lead to recurrence of portal hypertension. In such cases, repeat endovascular intervention becomes both feasible and necessary to restore shunt patency. The article presents two clinical cases describing various endovascular techniques for correcting dysfunction of previously established portocaval shunts, aimed at reducing the portosystemic gradient.