Transjugular intrahepatic portosystemic shunt (TIPS) creation treats complications of portal hypertension in appropriately selected patients by lowering the portal venous pressure. While this can be a lifesaving intervention, portal venous flow diversion is not without potential consequences. Overshunting can lead to hepatic decompensation and encephalopathy. TIPS reduction and TIPS occlusion are therapeutic options used to mitigate overshunting, with reduction being the initial alternative due to retained shunt patency and lower potential for venous thrombosis. Patient selection, techniques for TIPS reduction, and patient outcomes are reviewed in this article.
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| http://dx.doi.org/10.1055/s-0043-1764286 | DOI Listing |
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Article Synopsis
- TIPS surgery is common for treating portal hypertension, impacting postoperative complications tied to the portal venous system's hemodynamics.
- The study utilizes computational modeling to evaluate hemodynamic outcomes based on varying shunt positions and geometrical simplification strategies, using clinical data from two patients.
- Results indicated that placing the shunt at the main portal vein is preferable for reducing postoperative portal pressure and wall shear stress, while underscoring the importance of model simplifications in simulations.
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