Complications of transjugular intrahepatic portosystemic shunt

a comprehensive review.

Arthur M. Freedman, A. J. Sanyal, J. Tisnado, P. E. Cole, M. L. Shiffman, V. A. Luketic, P. P. Purdum, M. D. Darcy, M. P. Posner

Research output: Contribution to journalReview article

252 Citations (Scopus)

Abstract

It is generally accepted that the transjugular intrahepatic portosystemic shunt (TIPS) procedure has lower morbidity and mortality rates than those of surgical shunting. Nevertheless, complications occur. The authors have reviewed their experience and that of other institutions in compiling an extensive list of complications. Complications are categorized according to those related to transhepatic needle puncture, transvenous access to the portal vein, portal venous cannulation, the stent, the puncture site, portosystemic shunting, and contrast material. Excluding hepatic encephalopathy and delayed stenosis or occlusion of the shunt, an overall complication rate of less than 10% can be expected for TIPS. The prevalence of aggravated or new cases of encephalopathy is 5%-35%, and over the long term, up to 75% of shunts may undergo stenosis or occlusion. The direct procedural mortality rate is less than 2%, and the 30-day mortality rate ranges from 4% to 45%, depending on several factors. The role to which TIPS is relegated will be influenced by the long-term success rate in the prevention of recurrent variceal hemorrhage.

Original languageEnglish (US)
Pages (from-to)1185-1210
Number of pages26
JournalRadiographics : a review publication of the Radiological Society of North America, Inc
Volume13
Issue number6
DOIs
StatePublished - Jan 1 1993
Externally publishedYes

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Transjugular Intrahepatic Portasystemic Shunt
Punctures
Mortality
Pathologic Constriction
Hepatic Encephalopathy
Brain Diseases
Portal Vein
Catheterization
Contrast Media
Needles
Stents
Hemorrhage
Morbidity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Complications of transjugular intrahepatic portosystemic shunt : a comprehensive review. / Freedman, Arthur M.; Sanyal, A. J.; Tisnado, J.; Cole, P. E.; Shiffman, M. L.; Luketic, V. A.; Purdum, P. P.; Darcy, M. D.; Posner, M. P.

In: Radiographics : a review publication of the Radiological Society of North America, Inc, Vol. 13, No. 6, 01.01.1993, p. 1185-1210.

Research output: Contribution to journalReview article

Freedman, Arthur M. ; Sanyal, A. J. ; Tisnado, J. ; Cole, P. E. ; Shiffman, M. L. ; Luketic, V. A. ; Purdum, P. P. ; Darcy, M. D. ; Posner, M. P. / Complications of transjugular intrahepatic portosystemic shunt : a comprehensive review. In: Radiographics : a review publication of the Radiological Society of North America, Inc. 1993 ; Vol. 13, No. 6. pp. 1185-1210.
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