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Semin intervent Radiol 2023; 40(01): 055-072
DOI: 10.1055/s-0043-1767670
Review Article

A Comprehensive Review of Transjugular Intrahepatic Portosystemic Shunt–Related Complications

Jorge E. Lopera
1   Department of Radiology, University of Texas Health Sciences Center at San Antonio, San Antonio, Texas
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Abstract

Transjugular intrahepatic portosystemic shunt (TIPS) is one of the most technically complex procedures in interventional radiology, the need to connect two veins with variable anatomy, located in two different planes in hard and many times small cirrhotic livers using a needle, can be quite challenging. Despite more than 30 years of performing TIPS, the complex hemodynamics of the portal system are not fully understood, and sometimes unpredictable alterations of the portal flow can lead to serious unexpected complications. The best strategies to prevent TIPS complications are optimal patient selection, meticulous technique, operator experience, and immediate correction of identified adverse events. The purpose of this article is to review the technical complications with TIPS, the unique complications related to the use of stent grafts, and the late complications after the procedure, with emphasis on ways to prevent and treat them.

Keywords

portal hypertension - transjugular intrahepatic portosystemic shunt - complications - interventional radiology


Publication History

Article published online:
04 May 2023

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