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TIPS: indications, Contraindications, and Evaluation

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Abstract

Purpose of Review

This review summarizes the current and emerging indications, contraindications, and evaluation for TIPS. In the last three decades of use, there have been substantial changes and progress in this field, including the use of controlled-expansion, covered stents, which has broadened the clinical uses of TIPS.

Recent Findings

Recent findings have rapidly expanded the indications for TIPS, including emerging uses in hepatorenal syndrome, hepatopulmonary syndrome and before abdominal surgery. The widespread use of controlled-expansion, covered stents has decreased rates of post-TIPS hepatic encephalopathy, opening TIPS to a larger patient population.

Summary

Overall, with newer stent technology and more research in this area, the clinical utility and potential of TIPS has rapidly expanded. Going forward, a renewed focus on randomized-control trials and long-term outcomes will be a crucial element to selecting appropriate TIPS recipients and recommending emerging indications for this procedure.

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Authors and Affiliations

  1. Department of Medicine, Division of Gastroenterology & Hepatology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 1900, Chicago, IL, 60611, USA

    Allison Carroll & Justin R. Boike

  2. Feinberg School of Medicine, Northwestern University, Chicago, USA

    Allison Carroll

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A.C. and J.B wrote the main manuscript text and prepared Tables 1 and 2.

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Correspondence to Justin R. Boike.

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Dr. Boike has received investigator-initiated grant funding and consulting fees from W. L. Gore and Associates, the manufacturer of TIPS endoprosthesis. W. L. Gore and Associates had no influence on the authoring of this article.

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Carroll, A., Boike, J.R. TIPS: indications, Contraindications, and Evaluation. Curr Gastroenterol Rep 25, 232–241 (2023). https://doi.org/10.1007/s11894-023-00884-7

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