Interventional Radiology - Transjugular Intrahepatic Portosystemic Shunt (TIPS)
Patients are referred from across Los Angeles county to hospitals staffed by RIMA radiologists to undergo transjugular intrahepatic portosystemic shunt (TIPS) procedures. These procedures are performed to treat portal hypertension which is often due to scarring of the liver (Cirrhosis). This condition leads to intestinal bleeding from varices as well as the buildup of fluid within the abdomen known as ascites. The procedure creates an artificial channel in the liver form the portal vein to a hepatic vein and decreases the effective vascular resistance of the liver.
The TIPS procedure is performed by interventional radiologists in a hospital special procedures suite. Access to the liver is gained via the jugular vein in the neck. The interventional radiologist places a guide wire and catheter into the vena cava and then into a hepatic vein. The shunt is created by advancing a special needle through the sheath system to connect the hepatic vein to the large portal vein. The channel for the shunt is created by inflating an angioplasty balloon within the liever along the tract created by the needle and completed by placing a special mesh tube known as a stent or endograft to maintain the tract between the higher pressure portal vein and the lower pressure hepatic vein.