Consistent changes in portal venous and hepatic arterial hemodynamics are normally seen on duplex sonography after placement of a TIPS. Duplex sonography accurately predicts shunt patency and dysfunction when compared with portal venography. Duplex sonography is an effective, noninvasive method of evaluating shunt function and should be considered for use as the primary imaging technique in routine follow-up after TIPS placement.

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TIPS creation is often useful in treatment of severe ascites not controlled with medical therapy. In patients with advanced liver and renal failure, TIPS creation is not associated with a definite benefit and may hasten death.