TIPS : follow-up imaging and revision procedure

TIPS patency can be assessed by different imaging techniques angiography, color Doppler sonography, CT angiography, scintigraphy. Percutaneous angiography with measurement of the portocaval pressure gradient is the gold standard in the diagnosis of shunt failure, but, because its invasive nature and the necessity of frequent control of the shunt function, a noninvasive procedure is preferable for routine checkup. Color Doppler sonography in intervals of 3 to 6 months, with the use of different criteria, is considered as an accurate imaging technique with a high degree of sensitivity and specificity to evaluate TIPS patency. Angiography is indicated when CDs is not successful or in each clinical recurrence. Revision procedure may restore shunt efficiency and is indicated when the TIPS patency is compromised.