Transjugular Intrahepatic Portalsystemic Shunt - TIPS is 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 mostly 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, which is called portal hypertension. As a result of the increase in pressure, blood flows back around the liver via small, unimportant viens that connect the portal vein with other veins within the abdomen. These veins enlarge and are referred to as varices - which can bleed or rupture - with possible death as a result.

By providing an artificial path for blood traveling form the intestines, through the liver, and back to the heart, TIPS reduces the pressure in the varices and prevents them from rupturing and bleeding. The shunt is passed down the jugular vein in the neck using x-ray guidance, and then is inserted between the portal and hepatic veins within the liver.

Main symptoms and complications of portal hypertension include the above varices, ascites, encephalopathy or confusion caused by poor liver function, and reduced levels of platelets or white blood cells.

TIPS procedure controls bleeding of varices in more than 90% of patients, but in 20% the shunt may narrow or blockage can occur causing varices to re-bleed. Follow-up ultrasound exams are performed frequently to monitor blood flow through the liver, and check for ascites.