link
Bookmarks
Transjugular Intrahepatic Portosystemic Shunt (TIPS)
Hee Sun Park, MD, PhD; Aya Kamaya, MD, FSRU, FSAR
To access 4,300 diagnoses written by the world's leading experts in radiology, please log in or subscribe.Log inSubscribe
0
5
2
1

KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              • Scanning Tips

                TERMINOLOGY

                • Abbreviations

                  • Transjugular intrahepatic portasystemic shunt (TIPS)
                • Definitions

                  • Shunt between portal vein (PV) and hepatic vein (HV) created typically with balloon-expandable polytetrafluoroethylene (PTFE)-covered stent graft
                  • Shunt dysfunction
                    • Reduction > 50% of shunt lumen
                    • Portosystemic gradient > 12-15 mm Hg
                    • Complete occlusion of shunt

                IMAGING

                • General Features

                  • Ultrasonographic Findings

                    • Angiographic Findings

                      • Other Modality Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Indications for TIPS

                                            • Relative Contraindications for TIPS

                                              DIAGNOSTIC CHECKLIST

                                              • Consider

                                                Selected References

                                                1. Li YH et al: Long-term shunt patency and overall survival of transjugular intrahepatic portosystemic shunt placement using covered stents with bare stents versus covered stents alone. Clin Radiol. 73(6):580-587, 2018
                                                2. Lee EW et al: Nationwide trends and predictors of inpatient mortality in 83884 transjugular intrahepatic portosystemic shunt. World J Gastroenterol. 22(25):5780-9, 2016
                                                3. Engstrom BI et al: Covered transjugular intrahepatic portosystemic shunts: accuracy of ultrasound in detecting shunt malfunction. AJR Am J Roentgenol. 200(4):904-8, 2013
                                                4. Kirby JM et al: Image-guided intervention in management of complications of portal hypertension: more than TIPS for success. Radiographics. 33(5):1473-96, 2013
                                                5. Sajja KC et al: Long-term follow-up of TIPS created with expanded poly-tetrafluoroethylene covered stents. Dig Dis Sci. 58(7):2100-6, 2013
                                                6. Wu Q et al: Transjugular intrahepatic portosystemic shunt using the FLUENCY expanded polytetrafluoroethylene-covered stent. Exp Ther Med. 5(1):263-266, 2013
                                                7. Gazzera C et al: Fifteen years' experience with transjugular intrahepatic portosystemic shunt (TIPS) using bare stents: retrospective review of clinical and technical aspects. Radiol Med. 114(1):83-94, 2009
                                                8. Kim MJ et al: Technical essentials of hepatic Doppler sonography. Curr Probl Diagn Radiol. 38(2):53-60, 2009
                                                9. Bauer J et al: The role of TIPS for portal vein patency in liver transplant patients with portal vein thrombosis. Liver Transpl. 12(10):1544-51, 2006
                                                10. Harrod-Kim P et al: Predictors of early mortality after transjugular intrahepatic portosystemic shunt creation for the treatment of refractory ascites. J Vasc Interv Radiol. 17(10):1605-10, 2006
                                                11. Benito A et al: Doppler ultrasound for TIPS: does it work? Abdom Imaging. 29(1):45-52, 2004
                                                12. Middleton WD et al: Doppler evaluation of transjugular intrahepatic portosystemic shunts. Ultrasound Q. 19(2):56-70; quiz 108 - 10, 2003
                                                13. Bodner G et al: Color and pulsed Doppler ultrasound findings in normally functioning transjugular intrahepatic portosystemic shunts. Eur J Ultrasound. 12(2):131-6, 2000
                                                14. Zizka J et al: Value of Doppler sonography in revealing transjugular intrahepatic portosystemic shunt malfunction: a 5-year experience in 216 patients. AJR Am J Roentgenol. 175(1):141-8, 2000
                                                Related Anatomy
                                                Loading...
                                                Related Differential Diagnoses
                                                Loading...
                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            • Scanning Tips

                                                              TERMINOLOGY

                                                              • Abbreviations

                                                                • Transjugular intrahepatic portasystemic shunt (TIPS)
                                                              • Definitions

                                                                • Shunt between portal vein (PV) and hepatic vein (HV) created typically with balloon-expandable polytetrafluoroethylene (PTFE)-covered stent graft
                                                                • Shunt dysfunction
                                                                  • Reduction > 50% of shunt lumen
                                                                  • Portosystemic gradient > 12-15 mm Hg
                                                                  • Complete occlusion of shunt

                                                              IMAGING

                                                              • General Features

                                                                • Ultrasonographic Findings

                                                                  • Angiographic Findings

                                                                    • Other Modality Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Staging, Grading, & Classification

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Indications for TIPS

                                                                                          • Relative Contraindications for TIPS

                                                                                            DIAGNOSTIC CHECKLIST

                                                                                            • Consider

                                                                                              Selected References

                                                                                              1. Li YH et al: Long-term shunt patency and overall survival of transjugular intrahepatic portosystemic shunt placement using covered stents with bare stents versus covered stents alone. Clin Radiol. 73(6):580-587, 2018
                                                                                              2. Lee EW et al: Nationwide trends and predictors of inpatient mortality in 83884 transjugular intrahepatic portosystemic shunt. World J Gastroenterol. 22(25):5780-9, 2016
                                                                                              3. Engstrom BI et al: Covered transjugular intrahepatic portosystemic shunts: accuracy of ultrasound in detecting shunt malfunction. AJR Am J Roentgenol. 200(4):904-8, 2013
                                                                                              4. Kirby JM et al: Image-guided intervention in management of complications of portal hypertension: more than TIPS for success. Radiographics. 33(5):1473-96, 2013
                                                                                              5. Sajja KC et al: Long-term follow-up of TIPS created with expanded poly-tetrafluoroethylene covered stents. Dig Dis Sci. 58(7):2100-6, 2013
                                                                                              6. Wu Q et al: Transjugular intrahepatic portosystemic shunt using the FLUENCY expanded polytetrafluoroethylene-covered stent. Exp Ther Med. 5(1):263-266, 2013
                                                                                              7. Gazzera C et al: Fifteen years' experience with transjugular intrahepatic portosystemic shunt (TIPS) using bare stents: retrospective review of clinical and technical aspects. Radiol Med. 114(1):83-94, 2009
                                                                                              8. Kim MJ et al: Technical essentials of hepatic Doppler sonography. Curr Probl Diagn Radiol. 38(2):53-60, 2009
                                                                                              9. Bauer J et al: The role of TIPS for portal vein patency in liver transplant patients with portal vein thrombosis. Liver Transpl. 12(10):1544-51, 2006
                                                                                              10. Harrod-Kim P et al: Predictors of early mortality after transjugular intrahepatic portosystemic shunt creation for the treatment of refractory ascites. J Vasc Interv Radiol. 17(10):1605-10, 2006
                                                                                              11. Benito A et al: Doppler ultrasound for TIPS: does it work? Abdom Imaging. 29(1):45-52, 2004
                                                                                              12. Middleton WD et al: Doppler evaluation of transjugular intrahepatic portosystemic shunts. Ultrasound Q. 19(2):56-70; quiz 108 - 10, 2003
                                                                                              13. Bodner G et al: Color and pulsed Doppler ultrasound findings in normally functioning transjugular intrahepatic portosystemic shunts. Eur J Ultrasound. 12(2):131-6, 2000
                                                                                              14. Zizka J et al: Value of Doppler sonography in revealing transjugular intrahepatic portosystemic shunt malfunction: a 5-year experience in 216 patients. AJR Am J Roentgenol. 175(1):141-8, 2000