1 The Barcelona Hepatic Hemodynamics Laboratory, Liver Unit, Hospital Clinic, Barcelona, Spain.
2 Universidad de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD).
The transjugular intrahepatic portosystemic shunt (TIPS) is a percutaneous imaging-guided procedure that effectively reduces portal pressure by diverting blood from the portal to the systemic circulation. Despite being a very effective treatment for portal hypertension-related complications, the use of TIPS was hampered for many years by the high rate of TIPS dysfunction, an issue that has become almost anecdotal since the introduction of covered stents.(1) (1)(1) Currently, development of post-TIPS hepatic encephalopathy and, much less frequently, post-TIPS liver and cardiac failure remain as the major complications of TIPS, limiting its use. Until effective preventive and/or therapeutic strategies are available, adequate patient selection is the best existing approach to diminish the rate of these TIPS complications.