This interventional radiology procedure is used to treat high blood pressure in the portal vein (the most important vessel supplying the liver) caused by liver malfunctioning.

A probe is inserted in the right jugular vein in the neck and advanced to the liver where a metal prosthesis is placed between a suprahepatic vein and a portal vein branch. This significantly decreases the risk of gastro-esophageal variceal bleeding and ascites collection, frequently occurring with portal hypertension.

Candidates to this treatment can be included in the liver transplant waiting list. The TIPS is performed whenever a patient is expected not to undergo transplant for over 3-6 months and has portal hypertension-induced complications such as gastro-esophageal variceal bleeding or collection of ascites that do not respond to diuretics (refractory). This procedure is also indicated against the Budd-Chiari's Syndrome that causes hepatic vein thrombosis. TIPS is contraindicated in case of total complete portal vein thrombosis, severe hepatic encephalopathy, and systemic infections.