📖 What is Transjugular Intrahepatic Portosystemic Shunt?
A Transjugular Intrahepatic Portosystemic Shunt is a channel created within the liver between the hepatic vein and the portal vein, using a covered metallic stent inserted via the jugular vein. It decompresses the portal venous system, reducing complications of portal hypertension.
Transjugular Intrahepatic Portosystemic Shunt is performed under conscious sedation, in the angiography suite. The procedure takes 1–2 hours. Patients are admitted for 48–72h of monitoring after the procedure.
🎯 Indications
- Refractory ascites — repeated paracentesis no longer adequate
- Acute variceal bleeding refractory to endoscopic treatment (rescue Transjugular Intrahepatic Portosystemic Shunt)
- Prevention of recurrent variceal haemorrhage (secondary prophylaxis)
- Budd-Chiari syndrome — hepatic vein occlusion
- Hepatorenal syndrome (HRS) — bridge to liver transplantation
- Portal vein thrombosis — in selected cases
❓ FAQs
Transjugular Intrahepatic Portosystemic Shunt itself is not easily reversible, but it can be narrowed (shunt reduction) or occluded if complications arise (particularly hepatic encephalopathy). Revision Transjugular Intrahepatic Portosystemic Shunt (re-stenting) is straightforward if the shunt thromboses.
Main risks: hepatic encephalopathy (new or worsening, in 20–35%), shunt thrombosis or stenosis (requiring revision), right heart failure (volume overload). All patients are discussed in a hepatology MDT before Transjugular Intrahepatic Portosystemic Shunt.
Modern covered PTFE-lined stents (Viatorr®) have primary patency rates of 80–90% at 2 years. Doppler ultrasound surveillance is performed at 1, 3, 6 and 12 months post-Transjugular Intrahepatic Portosystemic Shunt.
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✓ Why this page is trustworthy
Written by the Interventional Radiology team at Cochin Hospital AP-HP, Université Paris Cité. Medically reviewed by an interventional radiologist of the department. Last updated: August 2026.