The Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure is used as a non operative treatment for portal hypertension. Portal hypertension results when there is increased resistance to blood flow through the liver on its way back to the heart. TIPS provides a newly created shunt for blood that bypasses the liver tissue, decreasing the resistance to blood flow and thereby decreasing the pressure that becomes built up in veins that drain into the liver.

Under portal hypertension the increased resistance to blood flow through the liver results in blood finding alternate pathways to return to the heart. The end result is a high volume of blood flowing through small veins that were not designed for such high flows. The two most common sites for blood to bypass the liver are in the esophagus and the anal canal. Increased bloodflow through these veins can result in esophageal varices and anal varices which are prone to rupture and hemorrhage, causing rapid death. Another common clinical symptom is ascites, or build up of fluid in the abdomen, which is caused by the increased pressure in veins draining to the liver and results in increased filtration of fluid into the extracellularly space around the vessels.

Because of the severe complications that can arise due to portal hypertension, TIPS was created to create a low resistance bypass around the congested liver thereby avoid the risks of esophageal varices, anal varices, and ascites. Often times it is used as a transition treatment to buy time for patients with end stage liver disease awaiting a liver transplant.