Sustained bacteremia associated with transjugular intrahepatic portosystemic shunt (TIPS)

Transjugular intrahepatic portosystemic shunt (TIPS) has become a routine p rocedure in patients with portal hypertension, yet there are few data conce rning the incidence of bacteremia associated with this shunt. All patients who underwent TIPS placement at a university hospital from January 1992 thr ough January 1999 were studied, Ninety-nine TIPS were placed, and 10 patien ts subsequently developed sustained bacteremia; 5 patients had no identifia ble source of bacteremia despite rigorous evaluation and were presumed to r epresent TIPS infections, for an estimated annual incidence of 7 cases/1000 TIPS procedures. Case patients developed bacteremia a median of 100 days a fter TIPS placement (range, 6-732 days). Bacteremia resolved in all patient s after treatment with appropriate intravenous antibiotics (median, 2 weeks of therapy). Although the incidence of TIPS-associated bacteremia appears low the increasing frequency of this procedure suggests that more informati on is needed to define this entity and to develop appropriate treatment rec ommendations.