TIPSS

Question 1

TIPSS

Answer 1

A TIPSS procedure involves the percutaneous creation of a low-pressure tract between the intrahepatic portal vein and the hepatic vein. This allows blood to bypass the liver and lowers portal pressure. The primary indications for TIPSS include uncontrolled variceal haemorrhage, refractory ascites, and hepatic pleural effusion.

Question 2

TIPSS - Contraindications

Answer 2

Absolute contraindications for TIPSS include:
Severe and progressive liver failure (Child-Pugh score >12 is associated with a high risk of early death)
Uncontrolled hepatic encephalopathy
Right-sided heart failure
Uncontrolled sepsis
Unrelieved biliary obstruction

Relative contraindications:
Severe uncorrectable coagulopathy (INR >5)
Thrombocytopenia <20 * 109/l
Portal and hepatic vein thrombosis
Pulmonary hypertension
Central hepatoma