TIPS Ultrasound Evaluation

Normal

• normal TIPS velocity: 90-190 cm/sec
• normal portal vein velocity before entering the TIPS: ~30 cm/sec
• phasic waveform
• the portal vein branches normally reverse their flow into the shunt

Stenosis

• color Doppler aliasing at the site of the stenosis
• velocity of >190 cm/sec at a stenotic segment
• velocity of <90 cm/sec in nonstenotic segments
• velocity <30 cm/sec in the pre-stent portal vein (accessory sign)
• complete occlusion: lack of color Doppler flow