In March of 2021 I had a TIPS procedure done, which proved to be successful up until approximately 2 months ago where it was discovered to be clotted off. The interventional radiologist who originally inserted the stent has scheduled me in this Wednesday to place a sleeve within the stent to open it up again and relieve the pressure on the surrounding veins to prevent bleeding.
For those who may be interested, TIPS is the acronym of a procedure called the transjugular Intrahepatic portosystemic stent which is placed in patients that have clots to their portal veins. Clots to the portal vein are typically caused by cirrhosis of the liver brought on by hepatitis, excessive misuse of alcohol, and clotting disorders. In my case the cause for my condition is much rarer and is labeled as an unknown genetic blood clotting disorder. Because doctors cannot remove the clot to my portal vein which has been there 20+ years, there were no other options available except through the PVR-TIPS which was researched and developed within the last few years. The PVR-TIPS is inserted through the spleen and jugular vein, as opposed to the traditional method through the liver. The stent helps to prevent bleeding and the formation of ascites.
TIPS is a tract typically created within the liver using x-ray guidance to connect two veins within the liver itself. In rarer cases, and most recently the method that was performed on me was performed by accessing the liver via the spleen and jugular vein. (See: https://www.portal-hypertension.com/2020/03/new-procedure-pvr-tips/). According to my doctors this option was the only option available for me as due to my anatomy, nothing else could even be attempted. The passage or shunt is kept open by the placement of a small, tubular metal device commonly called a stent.
During a TIPS procedure, interventional radiologists use image guidance to make a tunnel through the liver to connect the portal vein (the vein that carries blood from the digestive organs to the liver) to one of the hepatic veins (three veins that carry blood away from the liver back to the heart). A stent is then placed in this tunnel to keep the pathway open.
Here is a link (https://cirrhosiscare.ca/tips/) for a new animated version of the TIPS which was recently created by the cirrhosis care team at the University of Alberta hospital in Edmonton, Alberta where I had my first procedure and will be back again tomorrow for a sleeve to be inserted into the stent to open it up again.
Having the rare condition of portal hypertension, means having increased pressure in the portal vein system. This pressure buildup can create all sorts of complications. It can cause blood to flow backward from the liver into the veins of the spleen, stomach, lower esophagus, and intestines, causing enlarged vessels referred to as varices, bleeding and the accumulation of in the abdomen. Portal hypertension can also occur in children, although children are much less likely to require a TIPS.
Of significant concern when this procedure is performed is the fact that one can develop encephalopathy Anytime blood bypasses the liver without being filtered can cause cognitive damage in many forms. From my own research this can occur between 5 to 35% of patients. For myself though, I feel really blessed to not have this occur so far, but most of all I am grateful for the 20+ years beyond my diagnosis for the life I have lived.
I never take for granted the excellent treatment I have received over the years by the specialists and doctors who have worked with me, and am fully aware that treatment options may not always be available for some in other parts of the world. I am thankful to God for sustaining me through the tough times, and for everyone who has journeyed with me all these years and shared with me their own individual stories concerning their own experiences. Your prayers and thoughts are much appreciated,