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A portosystemic shunt or portasystemic shunt (medical subject heading term; PSS), also known as a liver shunt, is a bypass of the liver by the body's circulatory system.It can be either a congenital (present at birth) or acquired condition and occurs in humans as well as in other species of animals.
The shunt is completed by placing a special mesh tube known as a stent or endograft to maintain the tract between the higher-pressure portal vein and the lower-pressure hepatic vein. After the procedure, fluoroscopic images are made to show placement. Pressure in the portal vein and inferior vena cava are often measured. [citation needed]
A transjugular intrahepatic portosystemic shunt (TIPS) involves the decompression of the high pressures in the portal circulation by placing a small stent between a portal and hepatic vein. This is done through radiologically guided catheters which are passed into the hepatic vein either through the internal jugular vein or the femoral vein ...
Shunts must be placed early after diagnosis for best results. [20] TIPS (transjugular intrahepatic portosystemic shunt) has replaced shunt surgery as it is less invasive and overcomes intrahepatic outflow obstruction by diverting hepatic and portal blood flow to the inferior vena cava. TIPS accomplishes the same goal as a surgical shunt but has ...
A portacaval shunt (portal caval shunt) is a treatment for high blood pressure in the liver. A transjugular intrahepatic portosystemic shunt (TIPS) is an artificial channel within the liver that establishes communication between the inflow portal vein and the outflow hepatic vein. It is used to treat portal hypertension.
The main treatment in those with refractory hepatic hydrothorax is the insertion of a transjugular intrahepatic portosystemic shunt (TIPS). TIPS decompresses the portal system, reducing portal venous pressure and fluid in the abdomen; it is estimated to work in 70-80% of cases.
Portal hypertension is a condition in which the blood pressure of the portal venous system is too high. It is often the result of cirrhosis of the liver. Liver cirrhosis can lead to increased intrahepatic vascular resistance and vasodilation of portal system arteries, both of which increase pressure in the portal vein. [ 4 ]
Portal hypertension is defined as increased portal venous pressure, with a hepatic venous pressure gradient greater than 5 mmHg. [3] [4] Normal portal pressure is 1–4 mmHg; clinically insignificant portal hypertension is present at portal pressures 5–9 mmHg; clinically significant portal hypertension is present at portal pressures greater than 10 mmHg. [5]