Primary creation of an externally constrained TIPS: a technique to control reduction of the portosystemic gradient

AJR Am J Roentgenol. 2015 Apr;204(4):868-71. doi: 10.2214/AJR.14.13104.


Objective: Transjugular intrahepatic portosystemic shunt (TIPS) creation increases the risk of hepatic encephalopathy due to overshunting. Techniques exist to secondarily reduce the shunt for refractory encephalopathy. The purpose of this article is to describe a technique for primary TIPS restriction using a balloon-expandable stent within the transvenous hepatic track followed by deployment of a self-expanding polytetrafluoroethylene-lined stent-graft within the balloon-expandable stent to create the TIPS.

Conclusion: This technique enables control over the degree of portosystemic shunting in elective TIPS creation.

Keywords: TIPS; TIPS reduction; hepatic encephalopathy; stent-graft; transjugular intrahepatic portosystemic shunt.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Ascites / etiology
  • Ascites / therapy*
  • Female
  • Hepatic Encephalopathy / etiology
  • Hepatic Encephalopathy / therapy*
  • Humans
  • Hydrothorax / etiology
  • Hydrothorax / therapy*
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / therapy*
  • Liver Cirrhosis / virology
  • Middle Aged
  • Polytetrafluoroethylene
  • Portasystemic Shunt, Transjugular Intrahepatic*
  • Stents


  • Polytetrafluoroethylene