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Transient hemodynamic instability caused by TIPS


Authors: David Schneider;  Vladimír Kojecký
Authors‘ workplace: Interní oddělení, Krajská nemocnice Tomáše Bati ve Zlíně
Published in: Vnitř Lék 2023; 69(E-4): 16-19
Category: Case reports
doi: https://doi.org/10.36290/vnl.2023.053

Overview

Variceal bleeding belongs to the one of the complications of portal hypertension and is a life-threatening condition. A transjugular intrahepatic portosystemic shunt (TIPS) is indicated in case of failure of the pharmacological and endoscopic therapy, even if it is associated with complications. Stent migration to the heart, is a rare event which may cause perforation of the right cardiac chambers or damage to the tricuspid valve. However, it may not be a problem in some cases. There are two approaches to extraction – percutaneous or surgical. Leaving the stent in situ is possible, especially in polymorbid patients. Choosing an optimal approach often requires interdisciplinary cooperation.

Keywords:

portal hypertension – stent migration – tricuspid regurgitation – endoscopic ligation – oesophageal varices – TIPS – variceal bleeding


Sources

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