Infection of transjugular intrahepatic portosystemic shunt devices: three cases and a review of the literature.

During the past decade, transjugular intrahepatic portosystemic shunting (TIPS) has become accepted as an alternative to the surgical shunt procedure for controlling the complications of portal hypertension, yet few data exist regarding infectious complications. The records of all patients who underwent a TIPS procedure during 1992-2000 at a single university teaching hospital were analyzed retrospectively to determine the rate and type of infections that occurred. A search of the English-language literature on the subject was conducted, and the findings were compared with our experience. Three cases of TIPS stent infection were identified out of 180 procedures performed during a 9-year period, resulting in an overall rate of infection of 1.7%. One of the patients was cured, and the other 2 died. A total of 21 cases of TIPS infection were identified from the literature search. A need exists for a standardized case definition for TIPS infection, and one is proposed.