Transjugular intrahepatic portosystemic shunts for portal hypertension.

TIPS has rapidly become a proven effective therapy for treatment of acute variceal bleeding and is probably an effective therapy for intractable ascites. Nonetheless, it is important to define the appropriate subpopulation best suited for the TIPS procedure. Given the poor long-term patency of TIPS and the need for close follow-up, TIPS is not an optimal therapy for an unreliable patient who is not a candidate for liver transplantation. In contrast, TIPS is especially useful in the patient anticipating liver transplantation soon after TIPS placement. Further study is needed to define the optimal use for TIPS.