Abstract
Percutaneous shunt revision is an effective means of treating Transjugular intrahepatic portosystemic shunt (TIPS) dysfunction and of maintaining shunt patency. Stenotic shunts may be treated from a femoral approach by dilatation alone or by restenting and dilatation. Technical success approaches 100%. Revision of TIPS occlusion is successful in more than 80% of patients. Recanalized shunts are usually restented and then dilated. Acute thrombus may be redirected into varices using a balloon occlusion catheter. Extension of thrombus into the main portal vein is a serious but uncommon complication of shunt occlusion that can be effectively treated during shunt revision. New, promising techniques for the prevention of TIPS stenosis include the use of polytetrafluoroethylene (PTFE)-covered stents and the creation of direct portacaval shunts using covered stent technology.
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