TIPS: Management of major procedural complications

In summary, the TIPS procedure is a complex, multi-step procedure with many opportunities for complications and failure. Some of these complications are lethal. With appropriate planning, technique, care, and caution, the vast majority of these complications may be avoided. When compared with surgical decompression of the portal system, the procedural and thirty-day morbidity and mortality of TIPS is significantly reduced, especially in very ill patients or those requiring emergent decompression for bleeding. As interventionalists gain more experience, complications will ultimately be reduced even further. If long-term patency issues can be resolved, the TIPS procedure may eventually replace all surgical shunts.