Transient hemodynamic instability caused by TIPS

Vnitr Lek. 2023 Summer;69(E-4):16-19. doi: 10.36290/vnl.2023.053.

Abstract

Variceal bleeding belongs to the one of the complications of portal hypertension and is a life-threatening condition. A transjugular intrahepatic portosystemic shunt (TIPS) is indicated in case of failure of the pharmacological and endoscopic therapy, even if it is associated with complications. Stent migration to the heart, is a rare event which may cause perforation of the right cardiac chambers or damage to the tricuspid valve. However, it may not be a problem in some cases. There are two approaches to extraction - percutaneous or surgical. Leaving the stent in situ is possible, especially in polymorbid patients. Choosing an optimal approach often requires interdisciplinary cooperation.

Keywords: TIPS; endoscopic ligation; oesophageal varices; portal hypertension; stent migration; tricuspid regurgitation; variceal bleeding.

MeSH terms

  • Esophageal and Gastric Varices* / complications
  • Esophageal and Gastric Varices* / therapy
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / therapy
  • Hemodynamics
  • Humans
  • Hypertension, Portal* / complications
  • Liver Cirrhosis / complications
  • Portasystemic Shunt, Transjugular Intrahepatic* / adverse effects