TIPS Full Form
TIPS stands for Transjugular Intrahepatic Portosystemic Shunt 1.
What the Procedure Involves
TIPS is an interventional procedure where a metal stent is placed inside the liver to create a bypass channel between the portal vein and hepatic vein, thereby reducing portal pressure 2. The procedure is performed by threading a wire through the jugular vein in the neck, then guiding it through the liver using X-ray guidance to create this intrahepatic shunt 2.
Key Technical Details
- The procedure typically takes 90-120 minutes and is performed under general anesthesia or deep sedation 2
- All TIPS procedures should use PTFE-covered stents as they provide better patency rates than bare metal stents 1, 3
- The portal pressure gradient should be reduced to <12 mmHg or by ≥20% of baseline for variceal bleeding 1
Primary Clinical Indications
The main established indications for TIPS include:
- Acute variceal bleeding refractory to endoscopic and drug therapy (salvage TIPS), though not recommended when Child-Pugh score >13 1, 4
- Prevention of recurrent variceal bleeding when standard endoscopic and medical therapies have failed 2, 4
- Refractory or recurrent ascites in selected patients who have failed standard medical therapy 1, 4
- Hepatic hydrothorax not responding to conventional therapy 1, 2
- Budd-Chiari syndrome in patients who fail medical therapy with anticoagulation or hepatic vein interventions 1, 4
Abbreviation Context
The abbreviation TIPS is consistently used throughout medical literature and guidelines to refer to this transjugular intrahepatic portosystemic shunt procedure 1.