TIPS: for the right patient at the right time

Recent clinical data and updated liver disease guidance recommend earlier transjugular intrahepatic portosystemic shunt (TIPS) for improved survival

For decades, TIPS procedures with covered stents have been studied as an option for patients with clinically significant portal hypertension.1 With the increasing prevalence of liver disease and cirrhosis, physicians now have updated guidance from the American Association for the Study of Liver Diseases (AASLD), the Advancing Liver Therapeutic Approaches group (ALTA) and European Association for the Study of the Liver (EASL) that suggests using a multidisciplinary approach that includes gastroenterology and hepatology, with TIPS earlier in the treatment algorithm, to achieve optimal patient care.1-3

Prevalence of cirrhosis and portal hypertension in U.S.

According to the latest prevalence data from 2018, 4.5 million U.S. adults are diagnosed with chronic liver disease. Late-stage liver disease, or cirrhosis, affects 1 in 400 adults.a Chronic liver disease was the 10th leading cause of death in the U.S. in 2022.4 Fortunately, now there is compelling evidence that suggests earlier TIPS procedures increase survival - without increasing complications - in patients having advanced liver disease with portal hypertension 5,6

Earlier TIPS means:

belly

3 in 1

Consider TIPS for patients

who are getting at least 3 large-volume paracenteses (LVPs) in 1 year, despite optimal medical therapy.1,3

clock-blue

72

Within 72 hours of admission

after first bleeding incident for select patients with variceal bleeding.1,3

a 1 in 400 U.S. adults (340.1 m) have cirrhosis.

  1. Boike JR, Thornburg BG, Asrani SK, et al. North American practice-based recommendations for transjugular intrahepatic portosystemic shunts in portal hypertension. Clinical Gastroenterology & Hepatology 2022;20(8):1636-1662.e36.

  2. Kaplan D, Ripoll C, Thiele M, et al. AASLD Practice Guidance on risk stratification and management of portal hypertension and varices in cirrhosis. Hepatology 2024;79(5):1180-1211.

  3. European Association for the Study of the Liver. EASL clinical practice guidelines on TIPS. Journal of Hepatology 2025;83(1):177-210.

  4. Centers for Disease Control and Prevention. (CDC). Accessed April 3, 2025. www.cdc.gov

  5. Bureau C, Thabut D, Oberti D, et al. Transjugular intrahepatic portosystemic shunts with covered stents increase transplant-free survival of patients with cirrhosis and recurrent ascites. Gastroenterology 2017;152(1):157-163. http://www.sciencedirect.com/science/article/pii/S00165085163511015

  6. Hernández-Gea V, Procopet B, Giráldez Á, et al. International Variceal Bleeding Observational Study Group and Baveno Cooperation. Preemptive-TIPS improves outcome in high-risk variceal bleeding: an observational study. Hepatology 2019;69(1):282-293. https://aasldpubs.onlinelibrary.wiley.com/doi/full/10.1002/hep.30182

  7. National Institutes of Health (NIH). Accessed April 3, 2025. www.nih.gov

  8. Portal hypertension. Cleveland Clinic. Updated October 2, 2022. Accessed April 8, 2025. www.my.clevelandclinic.org/health/diseases/4912-portal-hypertension

This information is intended for education and awareness only. Patients should consult their physician for information on the risks associated with the devices and surgical procedures discussed on this website. All surgical procedures carry potential health risks. Not all patients will be candidates for treatment with these devices, and individual outcomes may vary. Always follow physician advice on your post-surgery care and recovery.

IFU Consult instructions

Refer to Instructions for Use at eifu.goremedical.com for a complete description of all applicable indications, warnings, precautions and contraindications for the markets where this product is available. RXOnly

INDICATIONS FOR USE IN THE U.S.: The GORE® VIATORR® TIPS Endoprosthesis is indicated for use in the de novo and revision treatment of portal hypertension and its complications such as variceal bleeding, gastropathy, ascites which recurs despite conventional treatment, and/or hepatic hydrothorax.

INDICATIONS FOR USE IN CANADA: The GORE® VIATORR® TIPS Endoprosthesis with Controlled Expansion is indicated for use in the treatment of portal hypertension and its complications such as variceal bleeding and ascites which recurs despite conventional treatment.

CONTRAINDICATIONS: There are no known contraindications for this device.

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