Shunt, transjugular, intrahepatic, portosystemic
A shunt (tube) placed between the portal vein which carries blood from the intestines to the liver and the hepatic vein which carries blood from the liver back to the heart. It is used primarily (but not exclusively) in patients with cirrhosis in which the scar tissue within the liver has blocked the flow of blood passing through the liver from the portal vein to the hepatic vein. The blockage increases the pressure in the portal vein leading to an increase in pressure in the portal vein (portal hypertension). As a result of the increase in pressure, blood flows around the liver via small, unimportant veins that connect the portal vein with other veins within the abdomen. These veins enlarge and are referred to as varices.
Unfortunately, one of the places varices form is in the stomach and lower esophagus, and these varices have a tendency to bleed massively, frequently causing death from exsanguination. By providing an artificial path for blood traveling from the intestines, through the liver, and back to the heart, TIPS reduces the pressure in the varices and prevents them from rupturing and bleeding. There are several types of shunts that are placed surgically. TIPS is a non-surgical way of placing a portosystemic shunt. The shunt is passed down the jugular vein in the neck by a radiologist using x-ray guidance. The shunt then is inserted between the portal and hepatic veins within the liver.
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