Bryan G. Belikoff MD, PhD, Presenter: Nothing to Disclose

Seung Kwon Kim MD, Abstract Co-Author: Nothing to Disclose

Carlos Javier Guevara MD, Abstract Co-Author: Nothing to Disclose

Kristen Alexa Lee MD, Abstract Co-Author: Nothing to Disclose

Guillermo Gonzalez-Araiza MD, Abstract Co-Author: Nothing to Disclose

Recognize the clinical manifestations after TIPS placement and know the various TIPS re-intervention techniques including basic and advanced TIPS revisions, TIPS reduction, parallel TIPS, and additional procedures such as Denver shunt and BRTO procedure according to clinical manifestations

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is an established and effective treatment for the complications of portal hypertension. Herein, we present a pictorial review of the basic to advanced re-intervention techniques after TIPS placement according to clinical manifestations.  Clinical manifestations/Procedure details: 1. Initial poor clinical response – TIPS revision, parallel TIPS, Denver shunt for intractable ascites 2. Hepatic encephalopathy or hepatic failure – TIPS reduction  3. Stenosis on Doppler US with/without symptom –TIPS venogram with/without revision 4. Total occlusion of TIPS stent on Doppler US or TIPS venogram         Parallel TIPS         Transhepatic or Transplenic approach          Thrombolysis – mechanical or catheter directed 5. Recurrent symptoms after initial clinical response          TIPS revision with possible variceal embolization for bleeding         Recurrent bleeding after TIPS revision with variceal embolization            --  Parallel TIPS or BRTO for gastric varices  

http://abstract.rsna.org/uploads/2014/14006766/14006766_a98p.pdf

Belikoff, B, Kim, S, Guevara, C, Lee, K, Gonzalez-Araiza, G, Pictorial Review of the Re-intervention Techniques after TIPS Placement (Transjugular Intrahepatic Portosystemic Shunt) According to Clinical Manifestations.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006766.html