What is a Transjugular Intrahepatic Portosystemic Shunt?

A transjugular intrahepatic portosystemic shunt is a medical device used to improve blood flow to and from the liver. It is primarily used to treat portal hypertension, a condition in which liver damage or a blockage causes blood to back up in the organ and reverse directions. The procedure to insert a shunt is usually performed by a clinical radiologist in a specialty surgical center or a hospital, and it usually takes about two hours. Most patients who receive shunts experience significant relief from their symptoms immediately and nearly full recoveries within 10 to 30 days.

In healthy people, the portal vein carries blood from the gastrointestinal tract to the liver, where it is processed and delivered back to the heart. Clots, physical abnormalities, and acquired disorders such as cirrhosis can impair the function of the portal vein, greatly decreasing the amount of blood that reaches the liver and sometimes stopping blood flow altogether. A transjugular intrahepatic portosystemic shunt opens up the portal vein and allows for more efficient blood flow to and from the organ.

A radiologist performs transjugular intrahepatic portosystemic shunt surgery while the patient is under general anesthesia. The specialist uses either ultrasound equipment or an x-ray tube called a fluoroscope to visualize the liver and portal vein. With imaging devices in place, a catheter is inserted through the jugular vein in the neck and guided to the end of the portal vein.

The actual transjugular intrahepatic portosystemic shunt is fixed to the end of the catheter and consists of a deflated balloon inside a wire or plastic mesh material. When the shunt is in place, the radiologist pumps up the balloon to expand the mesh and open the vein. The balloon is then deflated and the catheter is carefully removed. The shunt maintains its expanded shape, and the portal vein is held open. Following the procedure, the patient is sent to a recovery room and monitored for several hours or days to make sure the surgery was successful.

In most cases, blood flow improves quickly and the symptoms that accompanied liver problems begin to dissipate after a transjugular intrahepatic portosystemic shunt is fitted into place. Patients are usually able to get out of bed and walk around within a few days, and most people can return to normal levels of physical activity in less than one month. The risk of complications is low, but it is possible for the shunt to become clogged or dislodged over time. Regular checkups are important to monitor overall health and plan for further treatment measures if necessary.