TIPS/DIPS Revision
After undergoing a TIPS or DIPS, the patient may have new or recurrent symptoms. Sometimes these symptoms are due to worsening liver disease. Sometimes they are due to the stent shunting too much blood from one side of the liver to the other. Most frequently, the symptoms are due to the stent starting to narrow or kink over time.
In any case, if a patient has a TIPS or a DIPS and recurrent symptoms, they may need to have their stent evaluated. This can sometimes be accomplished with ultrasound, CT, or MRI. Sometimes, however, it requires a venogram with reduction or venoplasty/stent placement.
This is done by using ultrasound to get into the vein of the neck (jugular vein). From there, a catheter is advanced through the veins of the chest into the veins of the liver and the stent. Pictures are taken and pressure are measured. Depending on the symptoms, we may do nothing, try to make the stent smaller, or try to open the stent up more with a balloon or another stent.
The procedure has a low risk of bleeding, infection, and damage to nearby organs. We typically perform this procedure on outpatients. All patients should refrain from eating and drinking for 6 hours prior to the procedure. Outpatients usually go home 1-3 hours after the procedure.
