Transjugular Intrahepatic Portosystemic Shunt (Pamphlet)

What are the risks of TIPS?

The risks associated with a TIPS procedure include:

• Hepatic encephalopathy - (characterized by confusion, excessive sleep, disorientation, or coma)
• Fever
• Infection, bruising or bleeding
• Post TIPS Cardiac failure
• Post TIPS kidney dysfunction
• Post TIPS Liver dysfunction
• Stiffness, bruising, or soreness in the neck

Rare risks are:

• Bleeding in the belly
• Blockage in the stent
• Cutting off blood vessels in the liver
• Heart problems or abnormal heart rhythms
• Infection of the stent

Post TIPS Care

• It usually needs one week of hospital stay for an uncomplicated recovery of a patient after the TIPS procedure.
• Head end to be elevated in immediate post TIPS period. Avoid straight lying (Supine) position.
• Consume a diet low in protein and salt in the first week. It willbe advised by the dietician.
• Fluids to be taken as advised. The daily intake of total fluids should not be more than the urine output of the previous day.
• The family member/relative should immediately consult your hepatologist if you experience disorientation or confusion. It maybe due to hepatic encephalopathy.
• The effect of TIPS are maximum from 2 to 3 weeks.
• Patients need to come for Follow-up at one month, six months, and each year after that. You may be prescribed routine X-ray, ultrasound study, and blood tests on follow up.

Warning Signs and symptoms: when should I call my doctor?

• Any episode of disorientation or confusion.
• Inability to concentrate, Slow speech, Sleep disturbances, increased Irritability
• Returning or worsening of symptoms such as ascites or bleeding in the vomitus, breathing difficulty
• Pain in the abdomen
• Fever

What is cirrhosis and what are its effects?

Cirrhosis of liver occurs when normal liver tissue is damaged and replaced by scar tissue. Most of the blood flowing through the liver comes from the portal vein. The scar tissue significantly slows the flow of blood through the liver. This reduction of blood flow due to cirrhosis causes an increase in the pressure within the liver.

The blood is diverted away to vessels surrounding the stomach and lower portion of the esophagus. Due to this increased blood flow these vessels become distended and tortuous, now, named as varices. They are very weak and easy to rupture, leading to medical urgency.

Cirrhosis also results in Ascites, causing abdominal swelling as a result of the accumulation of fluid in the abdominal cavity.

How does a TIPS help?

In TIPS procedure a new route is created within the liver, to direct the flow of blood into the large blood vessels. The blood is now routed to the heart. A TIPS stent placed inside this channel allows a portion of excess blood to bypass the liver, reducing pressure in the liver and the associated complications

What are the benefits of TIPS?

The TIPS procedure is a minimally invasive procedure.
Reduced recovery time and the timespent in the hospital.

Reduction or complete resolution of ascites. Tapping of ascites and the treatment of varicesare needed less frequently or not at all.

Less recurrence of episodes of bleeding in the vomitus.
Quality of life improves. TIPS is a bridge till the liver transplant surgery is performed

What happens during a TIPS procedure?

TIPS procedure is accomplished through a minimally invasive procedure under anesthetic care. TIPS procedure typically takes 2–3 hours to perform.

You will ensure to not to eat or drink for about 6 to 8 hours before the procedure.

During the TIPS procedure, cardiac monitors are attached to your body to track your heart rate,rhythm and blood pressure.

You will also have an intravenous line in your arm to administer medications during the procedure.

A wire through introducer sheath is placed through a small skin puncture, entering into your neck vein usually on the right side.

The wire is advanced till liver to create a tunnel between the damaged liver and main blood supply.

A special balloon is used to enlarge the liver tunnel. A TIPS is inserted into the tunnel to help it remain open.

Disclaimer: This content is for educational purposes only.