title: Techniques for Transjugular Intrahepatic Portosystemic Shunt Reduction and Occlusion.
abstract: Transjugular intrahepatic portosystemic shunts (TIPS) effectively lower portal pressure and are commonly used to manage selected patients with variceal bleeding. Unfortunately, significant consequences are not infrequently encountered as a result of this diversion of portal venous flow. These consequences include disabling hepatic encephalopathy as well as hepatic decompensation. To manage these complications, therapeutic options include TIPS reduction and TIPS occlusion. TIPS reduction is the favored technique because of the potential for venous thrombosis and recurrent variceal hemorrhage after acute TIPS occlusion. Techniques and indications for TIPS reduction and TIPS occlusion are reviewed.
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA. Electronic address: andrew.taylor@ucsf.edu.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Taylor
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA.
authors.forename: Kanti P
authors.initials: KP
authors.lastname: Kolli
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA.
authors.forename: Robert K
authors.initials: RK
authors.lastname: Kerlan
mesh_terms: D021721:Balloon Occlusion; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D006501:Hepatic Encephalopathy / Q000175:diagnosis / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008670:Metals; D010690:Phlebography; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects*; D011474:Prosthesis Design; D012086:Reoperation; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
chemical_list: D008670:Metals
keywords: TIPS reduction; hepatic encephalopathy; portal hypertension; shunt