“…[5][6][7] In some cases, stents may migrate backwards into the portal system or shift into the right heart or even reach the pulmonary arteries that can result in various complications, including tricuspid valve insufficiency, damage to the pulmonary arteries, and embolism or occlusion of the pulmonary vasculature. 6,7 Consequently, it is of great importance to exercise caution during the placement of TIPS devices and to ensure complete deflation of balloons before undertaking any manipulations 3,8 In this case, it is noteworthy that secondary stenting, which is mandatory especially in cases of occlusion, significantly increased the risk of migration. The ideal TIPS configuration involves a direct conduit between the right or middle hepatic vein and the right portal vein, a geometry that minimizes the risk of migration.…”