Abstract
Transjugular intrahepatic portosystemic shunt (TIPS) creation treats complications
of portal hypertension in appropriately selected patients by lowering the portal venous
pressure. While this can be a lifesaving intervention, portal venous flow diversion
is not without potential consequences. Overshunting can lead to hepatic decompensation
and encephalopathy. TIPS reduction and TIPS occlusion are therapeutic options used
to mitigate overshunting, with reduction being the initial alternative due to retained
shunt patency and lower potential for venous thrombosis. Patient selection, techniques
for TIPS reduction, and patient outcomes are reviewed in this article.
Keywords
occlusion - overt hepatic encephalopathy - portal hypertension - TIPS reduction -
varices - interventional radiology
