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Tips (Transjugular Intrahepatic Portosystemic Shunt)
WHAT YOU NEED TO KNOW:
A transjugular intrahepatic portosystemic shunt (TIPS) is a channel made inside your liver to increase blood flow. The shunt reduces swelling in your abdomen, and lowers portal hypertension. TIPS may also reduce fluid buildup in your abdomen.
HOW TO PREPARE:
Before your procedure:
- You or a close family member will be asked to sign a legal document called a consent form. It gives healthcare providers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
- Arrange to have someone drive you home after the procedure.
- Tell your healthcare provider if you have any blood clotting problems or if you use medicine to thin your blood.
- Tell your provider about all medicines, vitamins, herbs, or supplements you currently use. Your provider will tell you if you need to stop any of these for the procedure and when to stop. He or she will tell you which to take or not take on the day of your procedure.
- You may need to take an antibiotic before your procedure. This medicine helps prevent or fight an infection caused by bacteria. Tell your provider about all your allergies, including to medicines or contrast liquid.
- You may need a liver ultrasound, MRI, or CT scan. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body. You may be given contrast liquid to help the pictures show up better. Tell the provider if you have ever had an allergic reaction to contrast liquid.
The night before your procedure:
You may be told not to eat or drink anything after midnight.
The day of your procedure:
An anesthesiologist will talk to you before your procedure. Tell him or her if you or anyone in your family had a problem with anesthesia. You may need medicine to keep you asleep and free from pain during the procedure.
WHAT WILL HAPPEN:
What will happen:
- Your healthcare provider will insert a needle into the vein in your neck. He or she will insert a catheter into your vein. The catheter will have a small balloon attached to it.
- Your provider will guide the catheter, stent (tube), and balloon down into your liver. He or she may also check the blood pressure in your veins with the inflated balloon. He or she will use the inflated balloon to make a channel in your liver. The stent will then be inserted into the channel.
- Your provider may do a procedure to stop your esophagus from bleeding before or after the TIPS placement. He or she will then place a bandage over the procedure area.
After your procedure:
You will be taken to a room where you can rest until you wake up. You will be taken to your room if you are staying at the hospital. Do not get out of bed until your healthcare provider says it is okay. Your healthcare provider may use another ultrasound after your procedure to see how well your stent is working. He or she may also need to do a test called a venogram to check blood flow through the veins in your liver.
CONTACT YOUR HEALTHCARE PROVIDER IF:
- You get sick with a cold or the flu.
- You have questions or concerns about your procedure.
Seek Care Immediately if
- You have worsened swelling in your abdomen.
- You have worsened bleeding in your esophagus, or you are coughing up blood.
- Rarely, a blood vessel or organ may be damaged during the procedure. This may cause bleeding inside your body. After your procedure, the stent could narrow and cause blood clots to form inside the stent. This may block blood flow, or increase blood pressure in your veins. The stent may move out of place or stiffen and stop working. You may also be at risk for a blood infection called sepsis. You may have new or worsened encephalopathy after your procedure. Encephalopathy is brain damage that causes mood and behavior changes. Your procedure may not reduce your portal hypertension. This means the bleeding in your esophagus and swelling in your abdomen may not stop. These problems may be life-threatening.
- You may need to receive another TIPS procedure if your stent has slipped or is not working. You may also need another TIPS procedure if the stent does not reduce your portal hypertension or other symptoms. You may have heart failure from the increased blood flow to your heart after your procedure. This procedure may not improve your chance for survival. The TIPS procedure may cause liver failure. You may still need a liver transplant after a TIPS procedure.
Care AgreementYou have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment.
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