COMPLICATIONS OF TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT - A COMPREHENSIVE REVIEW

it is generally accepted that the transjugular intrahepatic portosyste mic shunt (TIPS) procedure has lower morbidity and mortality rates tha n those of surgical shunting. Nevertheless, complications occur. The a uthors have reviewed their experience and that of other institutions i n compiling an extensive list of complications. Complications are cate gorized according to those related to transhepatic needle puncture, tr ansvenous access to the portal vein, portal venous cannulation, the st ent, the puncture site, portosystemic shunting, and contrast material. Excluding hepatic encephalopathy and delayed stenosis or occlusion of the shunt, an overall complication rate of less than 10% can be expec ted for TIPS. The prevalence of aggravated or new cases of encephalopa thy is 5%-35%, and over the long term, up to 75% of shunts may undergo stenosis or occlusion. The direct procedural mortality rate is less t han 2%, and the 30-day mortality rate ranges from 4% to 45%, depending on several factors. The role to which TIPS is relegated will be influ enced by the long-term success rate in the prevention of recurrent var iceal hemorrhage.