How is TIPS patency followed?
- TIPS patency can be followed noninvasively by color Doppler ultrasound or venography.
- Protocols differ among institutions.
- Two-year primary patency rates with the use of the Viatorr stent graft are 76% to 84%, and thus the need for frequent routine ultrasound surveillance is in question.
- If an early ultrasound evaluation is performed, it should be done at least 5 days after TIPS creation because air bubbles in the expanded polytetrafluoroethylene fabric create gas artifacts, which do not allow complete visualization and evaluation in the first 2 to 4 days.
- If the patient becomes symptomatic (e.g., variceal bleeding or ascites) or if significant interval change is demonstrated by ultrasound, venography with therapeutic intervention should be performed to restore normal shunt function.
