Comprehensive review of TIPS technical complications and how to avoid them

Ron C. Gaba; Vishal L. Khiatani; M. Grace Knuttinen; Benedictta O. Omene; Tami C. Carrillo; James T. Bui; Charles A. Owens

doi:10.2214/AJR.10.4819

Comprehensive review of TIPS technical complications and how to avoid them

Ron C. Gaba, Vishal L. Khiatani, M. Grace Knuttinen, Benedictta O. Omene, Tami C. Carrillo, James T. Bui, Charles A. Owens

Diagnostic Radiology

Research output: Contribution to journal › Review article › peer-review

54 Scopus citations

Abstract

OBJECTIVE. The goal of this article is to describe potential technical complications related to transjugular intrahepatic portosystemic shunts (TIPS) placement and to discuss strategies to avoid and manage complications if they arise. CONCLUSION. TIPS is an established interventional therapy for complications of portal hypertension. Although TIPS remains a relatively safe procedure, direct procedure-related morbidity rates are as high as 20%. The technical complexity of this intervention increases the risk for methodologic mishaps during all phases of TIPS placement, including venous access and imaging, transhepatic needle puncture, shunt insertion, and variceal embolization. Thus, interventional radiologists require a thorough stepwise understanding of TIPS insertion, possible adverse sequela, and technical tips and tricks to maximize the safety of this procedure.

Original language	English (US)
Pages (from-to)	675-685
Number of pages	11
Journal	American Journal of Roentgenology
Volume	196
Issue number	3
DOIs	https://doi.org/10.2214/AJR.10.4819
State	Published - Mar 2011

Keywords

Complication
Interventional radiology
Portal hypertension
Transjugular intrahepatic portosystemic shunt (TIPS)

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging

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10.2214/AJR.10.4819

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title = "Comprehensive review of TIPS technical complications and how to avoid them",

abstract = "OBJECTIVE. The goal of this article is to describe potential technical complications related to transjugular intrahepatic portosystemic shunts (TIPS) placement and to discuss strategies to avoid and manage complications if they arise. CONCLUSION. TIPS is an established interventional therapy for complications of portal hypertension. Although TIPS remains a relatively safe procedure, direct procedure-related morbidity rates are as high as 20%. The technical complexity of this intervention increases the risk for methodologic mishaps during all phases of TIPS placement, including venous access and imaging, transhepatic needle puncture, shunt insertion, and variceal embolization. Thus, interventional radiologists require a thorough stepwise understanding of TIPS insertion, possible adverse sequela, and technical tips and tricks to maximize the safety of this procedure.",

keywords = "Complication, Interventional radiology, Portal hypertension, Transjugular intrahepatic portosystemic shunt (TIPS)",

author = "Gaba, {Ron C.} and Khiatani, {Vishal L.} and Knuttinen, {M. Grace} and Omene, {Benedictta O.} and Carrillo, {Tami C.} and Bui, {James T.} and Owens, {Charles A.}",

year = "2011",

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AU - Gaba, Ron C.

AU - Khiatani, Vishal L.

AU - Knuttinen, M. Grace

AU - Omene, Benedictta O.

AU - Carrillo, Tami C.

AU - Bui, James T.

AU - Owens, Charles A.

PY - 2011/3

Y1 - 2011/3

N2 - OBJECTIVE. The goal of this article is to describe potential technical complications related to transjugular intrahepatic portosystemic shunts (TIPS) placement and to discuss strategies to avoid and manage complications if they arise. CONCLUSION. TIPS is an established interventional therapy for complications of portal hypertension. Although TIPS remains a relatively safe procedure, direct procedure-related morbidity rates are as high as 20%. The technical complexity of this intervention increases the risk for methodologic mishaps during all phases of TIPS placement, including venous access and imaging, transhepatic needle puncture, shunt insertion, and variceal embolization. Thus, interventional radiologists require a thorough stepwise understanding of TIPS insertion, possible adverse sequela, and technical tips and tricks to maximize the safety of this procedure.

AB - OBJECTIVE. The goal of this article is to describe potential technical complications related to transjugular intrahepatic portosystemic shunts (TIPS) placement and to discuss strategies to avoid and manage complications if they arise. CONCLUSION. TIPS is an established interventional therapy for complications of portal hypertension. Although TIPS remains a relatively safe procedure, direct procedure-related morbidity rates are as high as 20%. The technical complexity of this intervention increases the risk for methodologic mishaps during all phases of TIPS placement, including venous access and imaging, transhepatic needle puncture, shunt insertion, and variceal embolization. Thus, interventional radiologists require a thorough stepwise understanding of TIPS insertion, possible adverse sequela, and technical tips and tricks to maximize the safety of this procedure.

KW - Complication

KW - Interventional radiology

KW - Portal hypertension

KW - Transjugular intrahepatic portosystemic shunt (TIPS)

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Comprehensive review of TIPS technical complications and how to avoid them

Abstract

Keywords

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