Anastomose portosystémique intrahépatique percutanée

Transjugular intrahepatic porto-systemic shunts (TIPS) have been developed in the 80's, for the treatment of portal hypertension complications. Their indications include active bleeding from gastro-esophageal varix, and control of refractory cirrhotic ascites, especially in patients awaiting liver transplantation. New indications include hepatic hydrothorax, hepato-renal failure, and the treatment of the Budd-Chiari syndrome. TIPS have been shown to provide better control than endoscopic sclerotherapy, in the prevention of re-bleeding from gastro-esophageal varix and in the treatment of refractory cirrhotic ascites. Complications of TIPS procedures are possible and include encephalopathy, stent occlusion and stenosis. Using Polythetrafluoroethylen covered endoprosthesis (EPTFE) should improve the permeability of the TIPS.