The management of portal hypertension has undergone significant changes in the last two decades, with advances in medical, endoscopic and interventional radiologic treatment options. Many methods have been incorporated to reduce portal venous pressure for the treatment of serious and life-threatening complications of advanced liver disease. Since its introduction more than a decade ago, the TIPS placement has become a fundamental treatment option.
In its most basic form, a TIPS is a percutaneously created shunt spanning the liver's portal and hepatic veins. The shunt is built inside the liver using interventional radiological techniques. This conduit shunt is associated with far less morbidity and mortality, and has replaced the surgical shunt in most centers throughout the world.
More than 70,000 TIPS have been created in the last 13 years, a meteoric rise compared with the number of surgical shunts performed in that therapy's 60-year history. It is expected that the number will increase as the worldwide incidence of hepatitis C-related cirrhosis continues to increase.