Shunt, transjugular intrahepatic portosystemic

A shunt that allows blood from the portal circulation (that supplies the liver) to flow into the systemic (general) circulation. Transjugular intrahepatic portosystemic shunt involves catheterization of a hepatic (liver) vein by the transjugular approach (through the jugular vein) followed by puncture of an intrahepatic portal vein and placement and expansion of a stent to connect the liver tissue at this juncture. This type of shunt has been used in the treatment of complications of portal hypertension (high blood pressure to the liver), particularly in patients with cirrhosis. The shunt helps remove fluid build-up from the abdomen appears to prolong the survival of patients with cirrhosis better than repeat draining of the excess fluid. The build-up of fluid in the abdomen (ascites) is common in patients with cirrhosis and can impair breathing due to pressure from the fluid on the diaphragm. The procedure is done in community hospitals as well as in university centers. The shunt is placed while the patient is under local anesthesia, eliminating the need for surgery. It forms a highly effective connection between the portal and systemic circulations. Complications of the procedure include encephalopathy (a disorder of the brain) as well as liver failure.