TIPS (Transjugular Intrahepatic Portosystemic Shunt)

PREOP EVALUATION

• Clinic Visit
• Schedule with anesthesia

TIMING / BED REST AFTER PROCEDURE

• Overnight admission to floor

ANTICOAGULATION/ANTIPLATELETS

• Aspirin or Plavix- Stop 7 days before biopsy
• Lovenox, Low Molecular Weight Heparin (LMWH), Arixtra – Stop 24h prior to procedure
• Pradaxa – stop 3 days prior to procedure if possible.  See “Warfarin” immediately below for “bridge” anticoagulation, if necessary (CONTACT IR physician if uncertain)
• Warfarin (Coumadin) – Depends upon procedure and indication, as well as the reason the patient is taking this medication (CONTACT IR physician or PA)

LOCATION OF THE PROCEDURE

• Cath lab

PREOPERATIVE ORDERS

• IV with NS (Normal Saline) 75ml/hr
• PT/INR, PTT, CBC, Chem Complete

FOLLOW UP

• 1-2wks Clinic with ultrasound of TIPS just before patient is seen
• 6 month clinic visit (no ultrasound)

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