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Semin intervent Radiol 2018; 35(05): 492-496
DOI: 10.1055/s-0038-1676092
Morbidity & Mortality
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Transhepatic Revision of Occluded Transjugular Intrahepatic Portosystemic Shunt Complicated by Endotipsitis

Anne Williams Darrow
1   Division of Interventional Radiology, Department of Radiology, University of Illinois Health, Chicago, Illinois
,
Ron C. Gaba
1   Division of Interventional Radiology, Department of Radiology, University of Illinois Health, Chicago, Illinois
,
R. Peter Lokken
2   Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
› Author Affiliations
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Publication Date:
05 February 2019 (online)

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A rare but potentially lethal complication of transjugular intrahepatic portosystemic shunt (TIPS) creation is stent infection, referred to as “endotipsitis.”[1] This condition—due to microorganism colonization of a TIPS stent graft with biofilm formation—is associated with high morbidity and mortality rates, and requires aggressive management with antibiotic therapy and possible removal of the infected device. Herein, we present a case of endotipsitis attributed to transhepatic revision of an occluded TIPS created 3 years earlier, leading to refractory sepsis requiring prolonged antibiotic therapy and hospitalization, and ultimately orthotopic liver transplantation (OLT). We further provide an overview of endotipsitis, its diagnosis, incidence, and management.