Peripheral Arterial Disease: Transhepatic Revision of Occluded Transjugular Intrahepatic Portosystemic Shunt Complicated by Endotipsitis

摘要

A rare but potentially lethal complication of transjugular intrahepatic portosystemic shunt (TIPS) creation is stent infection, referred to as “endotipsitis.” 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.