Affordable TIPS Procedure Cost in Hyderabad, India

The TIPS procedure is recommended when increased pressure in the portal vein causes serious complications that cannot be adequately controlled with medicines, endoscopic procedures, dietary changes, or repeated fluid drainage. Before recommending TIPS, doctors carefully assess the patient’s liver function, heart health, kidney function, overall condition, and risk of complications.

Common Conditions Indicating the Need for a TIPS Procedure

• Recurrent variceal bleeding:  Portal hypertension can cause enlarged veins, called varices, to develop in the food pipe or stomach. These veins may rupture and cause severe internal bleeding. TIPS procedure reduces pressure in the portal vein and lowers the risk of further bleeding.
• Refractory ascites:  Ascites is the accumulation of fluid in the abdomen due to advanced liver disease. TIPS may be considered when the fluid repeatedly returns or does not improve despite a low-salt diet, medicines, and repeated fluid drainage. TIPS can help decrease fluid accumulation and relieve abdominal swelling, discomfort, and breathing difficulty.
• Hepatic hydrothorax: In some patients with liver cirrhosis, fluid collects around the lungs, usually on the right side of the chest. This condition causes symptoms like breathlessness, cough, and chest discomfort. TIPS is suggested when fluid continues to return even after taking medical treatment and repeated thoracentesis.
• Uncontrolled acute variceal bleeding: In emergency situations, TIPS may be performed when severe bleeding from oesophageal or gastric varices cannot be controlled through medicines and endoscopy. The shunt helps quickly lower portal vein pressure and control potentially life-threatening bleeding.
• Budd–Chiari syndrome: Budd–Chiari syndrome occurs when the veins carrying blood out of the liver become blocked. This can cause liver enlargement, abdominal pain, ascites, and liver damage. In selected patients, TIPS creates an alternative pathway for blood flow and helps reduce congestion within the liver.
• Portal vein thrombosis: In carefully selected patients, TIPS may be used when a blood clot blocks or narrows the portal vein and causes complications of portal hypertension. The procedure may help restore blood flow and reduce pressure, particularly when other treatment options are unsuitable.

There are different TIPS procedures performed, which depend on the patient's liver condition, the underlying cause of portal hypertension, and the clinical indication.

Covered stent TIPS

This is the most commonly preferred form of TIPS. A specially covered stent is placed to keep the newly created channel open, improve blood flow, and reduce the risk of narrowing or blockage over time.

Uncovered stent TIPS

In this approach, a bare-metal stent is used to maintain the shunt. It can effectively reduce portal pressure, but it has a higher chance of narrowing or blockage compared with covered stents and is therefore used less commonly today.

Elective TIPS procedure 

TIPS is a planned procedure performed after a detailed evaluation when the patient’s condition is stable. It may be recommended for recurrent ascites, hepatic hydrothorax, or repeated complications of portal hypertension.

Emergency or rescue TIPS

Emergency TIPS procedure is performed when urgent treatment is needed, especially for severe bleeding from oesophageal or gastric varices that cannot be controlled with medicines or endoscopic treatment.

TIPS revision procedure

A TIPS revision procedure is done when an existing shunt becomes narrowed, blocked, or does not function properly as expected. The interventional radiologist may reopen the channel, widen it, or place an additional stent to restore blood flow.

Ultrasound- and fluoroscopy-guided TIPS

TIPS procedure is conducted under ultrasound and fluoroscopy guidance. These imaging techniques help the interventional radiologist locate the blood vessels, create the shunt accurately, and place the stent safely.

Stent Types Used in TIPS

• Different types of stents may be used during the procedure depending on the patient's condition and clinical requirements.
• Bare metal stent: An older option that is now used less frequently because it has a higher chance of narrowing over time.
• Covered (PTFE-covered) stent: The preferred and most commonly used option, offering better long-term patency and reducing the risk of shunt blockage.

Note: The total cost of TIPS procedure may vary depending on the type of stent used, the complexity of the procedure, imaging requirements, and the patient's overall medical condition.

After the procedure, careful follow-up and adherence to what the doctor has instructed are important to ensure proper recovery, maintain shunt function, and reduce the risk of complications.

• It is advised to attend all scheduled follow-up appointments for clinical evaluation, blood tests, imaging, and monitoring of shunt function.
• It is recommended to keep the catheter insertion site (usually in the neck) clean and dry, and follow the proper wound care instructions provided by the healthcare team.
• It is suggested to avoid heavy lifting, strenuous activities, or vigorous exercise for a few days or as advised by your doctor.
• It is recommended to take all prescribed medications, including those to help prevent hepatic encephalopathy or manage liver disease, exactly as directed.
• It is advised to follow the recommended diet, including sodium restriction if prescribed, and avoid alcohol to help protect liver function.
• It is suggested to watch for symptoms such as increasing abdominal swelling, vomiting blood, black stools, confusion, severe abdominal pain, fever, or worsening shortness of breath, and to seek immediate medical attention if they occur.
• It is recommended to undergo periodic Doppler ultrasound examinations or other imaging studies to ensure that the TIPS shunt remains open and functions properly.
• It is advised to continue regular follow-up with your hepatologist, gastroenterologist, or interventional radiologist for ongoing management of portal hypertension and the underlying liver disease.