Percutaneous creation of direct intrahepatic portosystemic shunts - an alternative for failed TIPS creation

Introduction: Direct intrahepatic portosystemic shunt creation is a feasible and safe alternative for transjugular intrahepatic portosystemic shunt creation. It needs equipment like endovascular ultrasound with restricted availability. We performed the procedure percutaneously with a common interventional armamentarium to make it more feasible.

Methods: Retrospective analysis of 8 percutaneous DIPS insertions between 2016 and 2020.

Results: The procedure was successful in 8/8 patients. There was no short-term death reported within 30 days. The longest reported patency is 5 years.

Conclusion: Percutaneous DIPS creation is a feasible alternative for failed TIPS. Percutaneously the procedure can be completed faster than conventional DIPS using only minimal puncture equipment.

Level of evidence: Level 4, Case Series.