Nurse Bob's MICU/CCU Survival Guide
Gastroenterology in Critical Care
Transjuglar Intrahepatic Portosystemic Shunt (TIPS)

I. Definition.
    A. An artificial channel in the liver connecting the portal vein to the hepatic vein.
    B.Created  within the blood vessels via the jugular vein. 

II. Indications
    A. Treatment of portal hypertension.
        1. May be due to cirrhosis of the liver.
        2. Esophageal varices
        3. Ascites.
    B. TIPS decreases the vascular resistance of the liver.
        1. R
esults  is a reduced portal venous pressure.
        2. Lowers the pressure on the blood vessels in the intestine so that future bleeding is less likely to occur.
        3. The reduced pressure also makes decreases ascities

III. The procedure.
    A.  Placed by interventional radiologist
    B. Guide wire and introducer placed.
    C. Access to the hepatic vein is gained near the center of liver.
    D. Balloon angioplasty is done and stent placed to maintain tract from portal vein to hepatic vein.
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