title: Consensus conference on TIPS management: Techniques, indications, contraindications.
abstract: The trans jugular intrahepatic Porto systemic shunt (TIPS) is no longer viewed as a salvage therapy or a bridge to liver transplantation and is currently indicated for a number of conditions related to portal hypertension with positive results in survival. Moreover, the availability of self-expandable polytetrafluoroethylene (PTFE)-covered endoprostheses has dramatically improved the long-term patency of TIPS. However, since the last updated International guidelines have been published (year 2009) new evidence have come, which have open the field to new indications and solved areas of uncertainty. On this basis, the Italian Association of the Study of the Liver (AISF), the Italian College of Interventional Radiology-Italian Society of Medical Radiology (ICIR-SIRM), and the Italian Society of Anesthesia, Analgesia and Intensive Care (SIAARTI) promoted a Consensus Conference on TIPS. Under the auspices of the three scientific societies, the consensus process started with the review of the literature by a scientific board of experts and ended with a formal consensus meeting in Bergamo on June 4th and 5th, 2015. The final statements presented here were graded according to quality of evidence and strength of recommendations and were approved by an independent jury. By highlighting strengths and weaknesses of current indications to TIPS, the recommendations of AISF-ICIR-SIRM-SIAARTI may represent the starting point for further studies.
authors.affiliation: Gastroenterologia Epatologia e Trapiantologia, Papa Giovanni XXIII Hospital, Bergamo, Italy. Electronic address: sfagiuoli@asst-pg23.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Fagiuoli
authors.affiliation: Dept. of Infectious Diseases, Hepatology Outpatients Unit, University of Pavia-Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Bruno
authors.affiliation: Gastroepatologia, AOU Città della Salute e della Scienza, Molinette Hospital, Torino, Italy.
authors.forename: Wilma
authors.initials: W
authors.lastname: Debernardi Venon
authors.affiliation: Department of Gastroenterology University of Modena and Reggio Emilia, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Schepis
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Vizzutti
authors.affiliation: Medical Liver Transplant Section, Department of Medical Sciences Experimental and Clinical, Internal Medicine, University of Udine, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Toniutto
authors.affiliation: Unità di Trapianto Multiviscerale, Gastroenterologia, Dipartimento di Scienze Chirurgiche e Gastroenterologiche, Università-Ospedale di Padova, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Senzolo
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Caraceni
authors.affiliation: Department of Internal Medicine, Policlinico IRCCS San Donato, University of Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Salerno
authors.affiliation: Internal Medicine and Hepatology Department of Medicine (DIMED), University of Padova, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Angeli
authors.affiliation: Dipartimento di Radiologia Diagnostica e Interventistica, UO di Radiologia Interventistica, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cioni
authors.affiliation: U.O.C. di Chirurgia Epatobiliare e del Trapianto Epatico, Azienda Ospedaliera Università di Padova, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Vitale
authors.affiliation: Department of Radiology S. Croce and Carle Hospital Cuneo, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Grosso
authors.affiliation: 2° Servizio Anestesia e Rianimazione-Ospedale Niguarda Ca Granda, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: De Gasperi
authors.affiliation: UOC Gastroenterologia Ospedale V Cervello, Palermo, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: D'Amico
authors.affiliation: Gastroepatologia, AOU Città della Salute e della Scienza, Molinette Hospital, Torino, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Marzano
mesh_terms: D001201:Ascites / Q000150:complications; D054855:Drug-Eluting Stents; D004932:Esophageal and Gastric Varices / Q000473:pathology; D006471:Gastrointestinal Hemorrhage / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery*; D007558:Italy; D008103:Liver Cirrhosis / Q000150:complications; D016031:Liver Transplantation; D011138:Polytetrafluoroethylene; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000379:methods / Q000592:standards*; D012955:Societies, Medical
chemical_list: D011138:Polytetrafluoroethylene
keywords: Ascites; Cirrhosis; GI bleeding; Liver transplantation; Portal hypertension; TIPS