Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure to create new connections between two blood vessels in your liver. You may need this procedure if you have very bad liver problems.

This is not surgery. It is done by a radiologist using x-ray. A radiologist is a doctor who uses imaging techniques to diagnose and treat diseases.

You will probably receive local anesthesia and medicine to relax you. This will make you pain free and sleepy, or you may have general anesthesia (asleep and pain-free).

Your radiologist will insert a catheter (a flexible tube) through your skin into a vein in your neck.

• On the end of the catheter is a balloon and a metal mesh stent (tube).
• Using x-ray equipment, the surgeon will guide the catheter into a vein in your liver.
• The balloon will be blown up to place the stent. You may feel a little pain when this happens.
• Your radiologist will use the stent to connect your portal vein to one of your hepatic veins.

This new pathway will allow blood to flow better. It will ease pressure on the veins of your stomach, esophagus, intestines, and liver.

Normally, blood coming from your esophagus, stomach, and intestines first flows through the liver. When your liver has a lot of damage, this blood cannot flow through it very easily. This is called portal hypertension (increased pressure and backup at the portal vein).

When this problem happens, you may have:

• Bleeding from veins of the stomach, esophagus, or intestines (variceal bleeding)
• Buildup of fluid in the belly (ascites)
• Buildup of fluid in the chest (hydrothorax)
• Clotting in a vein that carries blood from the liver to the heart (Budd-Chiari syndrome)

This procedure allows your blood to flow better in your liver, stomach, esophagus, and intestines, and then back to your heart.