Interventional Radiology: Transjugular Intrahepatic Portosystemic Shunt
TIPS (transjugular intrahepatic portosystemic shunt) is a percutaneous procedure for forming a new intrahepatic shunt in which the hepatic vein connects to the portal vein. Portal venous blood flows out through this shunt resulting in a decrease in the portal pressure. TIPS was first reported by Dr. Rosch in 1969 and clinically applied with metallic stent in 1989. Since then TIPS has been widely performed in the USA and Europe. Indications for TIPS include refractory esophageal varices, refractory ascites, and portal hypertensive gastropathy. From the laboratory data, less than 18 of MELD score are recommended for indication. In Japan, TIPS is not approved by the Ministry of Health, Labour and Welfare, so it has not been performed widely.
KeywordsPortal decompression Esophageal varices Refractory ascites Portal hypertensive gastropathy
- 5.Nakamura K, et al. A clinical experience of transjugular intrahepatic portosystemic shunt. J Jpn Soc Gastroenterol. 1994;91:171–9.Google Scholar
- 8.Haskal ZJ. Transjugular intrahepatic portosystemic shunts. In: Kandarpa K, Machan L, editors. Handbook of interventional radiologic procedures. 4th ed. Baltimore: Lippincott Williams & Wilkins; 2011. p. 390–7.Google Scholar
- 10.Report of current state of portal hypertension in Japan edited by Japanese Society of Portal Hypertension; 1990. JSPH.Google Scholar
- 17.Lee SJ, Kim SU, Kim MD, Kim YH, Kim GM, Park SI, Won JY, Lee DY, Lee KH. Comparison of treatment outcomes between balloon-occluded retrograde transvenous obliteration and transjugular intrahepatic portosystemic shunt for gastric variceal bleeding hemostasis. J Gastroenterol Hepatol. 2017;32:1487–94. https://doi.org/10.1111/jgh.13729.CrossRefPubMedPubMedCentralGoogle Scholar