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TIPS/Vascular Hepatopathies

The transjugular intrahepatic portosystemic shunt (TIPS) is an important interventional therapy method in the treatment of portal hypertension. The most important indications for TIPS are the presence of refractory (treatment resistant) ascites and/or the occurrence of unstoppable endoscopic bleeding of the esophageal varices. Rarer indications include hepatorenal syndrome, refractory hepatogenic pleural effusion or hypertensive gastropathy bleeding.

The most important and common hepatic vascular liver diseases are portal vein thrombosis (PVT) and Budd-Chiari syndrome (BCS), an acute occlusion (blockage) of the hepatic veins. Both diseases cause portal hypertension. The choice of treatment is complex, and besides systemic anticoagulation includes the possibility of either interventional catheter-based lysis therapy or TIPS.

The TIPS system is a procedure introduced in 1989 by a working group in Freiburg which has been further developed over the years. The resulting high level of expertise in the diagnosis and treatment of portal hypertension, benefits patients in various ways. In the TIPS department, patients with complications of portal hypertension are cared for, TIPS indications are evaluated and TIPS operation follow-ups are conducted.

Interventional procedures - in particular the TIPS system but also transjugular liver biopsies, pressure measurements or local lysis catheters - can be carried out using interdisciplinary endoscopy and interventional radiology. Patients receive both pre- and aftercare in the various stations of our department.