You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page.
Turn on more accessible mode
Turn off more accessible mode
Skip Ribbon Commands
Skip to main content
Turn off Animations
Turn on Animations
CTDetailNew
It looks like your browser does not have JavaScript enabled. Please turn on JavaScript and try again.
Appointment
Find a Condition or Treatment
Find a Doctor
Menu
MAIN
Back to Home
About Us
Corporate Profile
Newsroom
Visitors Information
Contact Us
Patient Care
Specialties & Services
Your Clinic Visit
Cancer Information & Patient Support
E-Services
Find a Doctor
Research & Innovation
Research Labs
Programmes
Facilities
Our Researchers
Clinical Trials
SingHealth Research
Education & Training
Overview
Professional Development
Division of Cancer Education
Events
SingHealth Academy
Careers
Sponsorship
Scholarships
Giving
Why Give
Get Involved
Your Gift at Work
Be Informed
Make a Gift
Our Campaign
Volunteer
Specialties & Services
Back to Home
Goh Cheng Liang Proton Therapy Centre
Haematology
Medical Oncology
Surgery & Surgical Oncology, SGH and NCCS
Radiation Oncology
Oncologic Imaging
Supportive & Palliative Care
Comprehensive Liver Cancer Clinic
Cancer Genetics Service
Lung Multidisciplinary Clinic
Nursing
NCCS Oncology @ SKH
NCCS Oncology Clinic @ CGH
Department of Psychosocial Oncology
Cancer Education and Information
Your Clinic Visit
Back to Home
Book an Appointment
When seeing a doctor
Pharmacy
Outpatient Pharmacy
Oncology Pharmacy
Search a medication
FAQ
Medicine
Charges & Payment
Financial Aid
Video Consultation
Rights & Responsibilities as a Patient
Cancer Information & Patient Support
Back to Home
For Patients
For Caregivers
Publications
Cancer Information Booklets
In Good Health
Inspirational Patient & Caregiver Awards
Patient Stories
E-Services
Back to Home
Make/Change/Cancel Appointment
Request for Medical Report
Health Buddy App
Find a Doctor
Home
to skip to the main content on a page
to skip to the main content on a page
About Us
Back to Home
Corporate Profile
Vision & Mission
NCCS Leadership
Annual Report
Awards
Key Milestones
Whistle-blowing Policy
Newsroom
Press Releases
Check Fake News
Visitors Information
Contact Us
Feedback Form
Patient Care
Back to Home
Specialties & Services
Goh Cheng Liang Proton Therapy Centre
Haematology
Medical Oncology
Surgery & Surgical Oncology, SGH and NCCS
Radiation Oncology
Oncologic Imaging
Supportive & Palliative Care
Comprehensive Liver Cancer Clinic
Cancer Genetics Service
Lung Multidisciplinary Clinic
Nursing
NCCS Oncology @ SKH
NCCS Oncology Clinic @ CGH
Department of Psychosocial Oncology
Cancer Education and Information
Your Clinic Visit
Book an Appointment
When seeing a doctor
Pharmacy
Medicine
Charges & Payment
Financial Aid
Video Consultation
Rights & Responsibilities as a Patient
Cancer Information & Patient Support
For Patients
For Caregivers
Publications
Patient Stories
E-Services
Make/Change/Cancel Appointment
Request for Medical Report
Health Buddy App
Find a Doctor
Research & Innovation
Back to Home
Research Labs
Cellular & Molecular Research
Medical Sciences
Clinical Trials & Epidemiological Sciences
NCCS Research Committee & Scientific Advisory Board
Research Divisions Organisation Chart
Programmes
Disease Focus
Research Themes
Joint Breast Cancer Registry
Asia-Pacific Hepatocellular Carcinoma Trials Group
The VICTORY Consortium
Facilities
Overview
Specialised Units
Shared Facilities
Shared Services
Research Contracts and Commercialisation
Our Researchers
Division of Medical Oncology
Division of Surgery & Surgical Oncology, SGH and NCCS
Division of Radiation Oncology
Division of Oncologic Imaging
Division of Supportive and Palliative Care
Cellular and Molecular Research
Division of Medical Sciences
Clinical Trials & Epidemiological Sciences
Research Biennial Book
Clinical Trials
About Clinical Trials
Current Clinical Trials
ECRU
About Clinical Trials & Epidemiological Sciences
Clinical Trials Office
Biostatistics and Epidemiology Unit
SingHealth Research
Education & Training
Back to Home
Overview
Professional Development
Continuing Medical Education
Continuing Nursing Education
Continuing Pharmacist Education
Division of Cancer Education
Undergraduate Education Unit
Postgraduate Education Unit
Nursing & Allied Health Education Unit
Faculty Development & Support Education Unit
Primary Care Oncology Education Unit
Communications, Mentoring, Ethics and Professionalism Education Unit
Medical Humanities Education Unit
Events
SingHealth Academy
Careers
Back to Home
Sponsorship
Career Conversion Programme
Scholarships
Giving
Back to Home
Why Give
About Us
Funding Innovative Research
Preventing Cancer
Advancing Medical Education
Helping Our Patients
Furthering Donor Impact
How Your Gift Helps
Get Involved
Honouring Your Gift
Become a Corporate Donor
Leave Your Legacy
Fundraise for Us
Join a Special Event
Your Gift at Work
Stories of Hope
Researchers in Action
Support for Patients
Our Work in the Community
Training Future Experts
Be Informed
Our Publications
Financial Statements
Make a Gift
Our Campaign
Make More Survivors
Jeans For Genes
Women VS Cancer
BCAM 2023
LCAM 2023
Volunteer
Home
>
Patient Care
>
Conditions and Treatment
>
TIPSS, BRTO and portal hypertension
>
Treatment
Facebook
WhatsApp
Email Us
share
Font Resize
A-
A
A+
Print
TIPSS, BRTO and portal hypertension
TIPSS, BRTO and portal hypertension - Treatments
TIPSS – transjugular intrahepatic portosystemic shunt
TIPSS is most often performed for patients with variceal bleeding unresponsive to optimal medical/ endoscopic therapy and in patients with refractory ascites. It is a minimally invasive procedure performed by an Interventional Radiologist. As it is a minimally invasive procedure, the recovery time is shorter. With the help of x-ray guidance, an artificial tunnel is created through the liver, connecting the portal vein to a hepatic vein (a blood vessel that carries blood away from the liver). Once the tunnel is created, a small metal device called a stent is placed inside the tunnel to keep it open. The stent allows blood to flow across the liver resulting in a drop in the portal vein pressure. The procedure is performed under general anaesthesia and you should plan to stay in hospital for one or more days after the procedure. Studies have shown that this procedure can successfully reduce variceal bleeding in more than 90% of patients. However, as with all procedures, there are risks involved. These include liver injury resulting in life threatening bleeding requiring a blood transfusion, increased confusion (encephalopathy), contrast allergy, kidney and heart failure.
Figure illustrating angiographic image of gastro-oesophageal varices and portal vein.
Figure illustrating creation of a tunnel within the liver by inflating an angioplasty balloon after placement of a TIPS stent.
Figure illustrating angiographic image after placement of TIPS stent and coil embolization of the varices.
BRTO – balloon retrograde transvenous obliteration
This procedure involves blocking the dilated abnormal veins near the stomach (gastric varices) and is an alternative to TIPSS. Gastric varices bleed less commonly and have a lower pressure. However, when they do bleed, patients deteriorate much worse than with oesophageal varices. The gastric varices are also more difficult to treat with endoscopy. BRTO treats varices but does not reduce portal vein pressure. Although BRTO can inprove confusion from encephalopathy and liver function temporarily, it can also worsen oesophageal varices and ascites. The procedure is a miminally invasive x-ray guided procedure performed by an Interventional Radiologist. A needle is used to gain access into the internal jugular vein in the neck and a tube is guided into the large veins near the stomach using x-ray guidance. Once in position, a balloon is inflated and foam (sodium tetradecyl sulphate 3%) in injected as as sclerosant agent.
TIPSS, BRTO and portal hypertension - Other Information
Display Entire Article +
Diagnosis
Pre-Surgery Preparation
Tags:
Octreotide,
Propranolol,
Vasopressin
Article contributed by
Vascular and Interventional Radiology
,
Singapore General Hospital
The information provided is not intended as medical advice.
Terms of use
. Information provided by
Our Breast Team
Filter:
By designation or sub-specialty
By Designation:
By Sub-Specialty:
TOP
[]
Related Conditions
Related Medicine
Octreotide
Propranolol
Vasopressin
View more
Healthy Living Tips
by
View more
Discover articles,videos, and guides afrom Singhealth's resources across the web. These information are collated, making healthy living much easier for everyone.
Managing Dementia Behaviours How to Manage Paranoia and Delusion
Managing Dementia Behaviours How to Manage Sundowning
Post-Stroke Exercises (Lower Limb Strength Training)
Post-Stroke Exercises (Upper Limb Strength Training)
×
SUBSCRIBE VIA EMAIL
Subscribe to our mailing list to get the updates to your email inbox...
Find a Doctor
Condition & Treatment
Home
Appointment
E-services