title: Causes of TIPS dysfunction.
abstract: OBJECTIVE
  Transjugular intrahepatic portosystemic shunt (TIPS) creation is an effective method to control portal hypertension. TIPS creations with bare stents have shown limited and unpredictable patency. In nearly all cases of rebleeding or recurrent ascites after TIPS creation, there is shunt stenosis or occlusion. The purpose of this article is to review the biologic and technical factors that predispose to TIPS failure and how the use of an expandable polytetrafluoroethylene (PTFE)-covered-stent has significantly improved TIPS patency.
  
  
  CONCLUSIONS
  Biologic and technical factors may predispose to shunt failure. The combination of improved technique and expandable PTFE has significantly improved TIPS patency. The need for follow-up venography and secondary interventions has been reduced significantly as a result of improved shunt patency.
authors.affiliation: Cardiovascular and Special Interventions, Department of Radiology, The University of Texas Health Science Center, Mail Code 7800, 7703 Floyd Curl Dr, San Antonio, TX 78229-3900, USA. curam@uthscsa.edu
authors.forename: Marco
authors.initials: M
authors.lastname: Cura
authors.forename: Alejandro
authors.initials: A
authors.lastname: Cura
authors.forename: Rajeev
authors.initials: R
authors.lastname: Suri
authors.forename: Fadi
authors.initials: F
authors.lastname: El-Merhi
authors.forename: Jorge
authors.initials: J
authors.lastname: Lopera
authors.forename: Ghazwan
authors.initials: G
authors.lastname: Kroma
mesh_terms: D000328:Adult; D001201:Ascites / Q000175:diagnosis / Q000209:etiology*; D001652:Bile Ducts / Q000293:injuries*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006504:Hepatic Veno-Occlusive Disease / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects*; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000209:etiology*