What is the most common complication following TIPSS?
TIPSS is a percutaneous procedure used for treatment of patients who have gastroesophageal varices in the setting of poal hypeension. It has largely replaced surgical poosystemic shunts due to the fact that it is both safe and effective while also providing a minimally invasive alternative to major abdominal surgery. TIPSS functions by creating an intrahepatic shunt between the poal and systemic circulation which causes a reduction in the poal pressure and ultimately in the blood flow through varices. It is accomplished by endovascular access through the jugular vein to a hepatic vein radical and subsequent creation of a needle tract that connects it to a branch of the poal vein. After dilation of the tract, a metallic stent is deployed to hold the new poosystemic connection open. Because this shunt reduces first pass metabolism of the liver, the most common complication of TIPS is encephalopathy which occurs in 25 to 30% of patients. Other complications such as hepatic ischemia, infection, renal failure, and hemorrhage may occur, but are rare
Encephalopathy
Hepatic ischemia
Infection
Life-threatening hemorrhage
Poal Hypeension