During a TIPS procedure, which vein is accessed via the jugular vein?

• A. Left hepatic vein
• B. Right hepatic vein
• C. Inferior vena cava
• D. Portal vein

Answer: (B)

In a Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure, the chosen approach typically involves accessing the right hepatic vein through the jugular vein. This is done to create a shunt that connects the portal vein to the hepatic vein, lowering portal venous pressure and alleviating complications of portal hypertension.

The procedure begins with catheter insertion via the jugular vein to reach the inferior vena cava, which subsequently leads to the right hepatic vein. The right hepatic vein is favored because it provides a direct and less tortuous path to the portal system, enhancing procedural efficiency and safety.

It's critical to note that, although other veins like the left hepatic vein could theoretically be accessed, the right hepatic vein is the preferred structure in clinical practice. The portal vein cannot be accessed directly via this route; rather, it is part of the anatomy that is targeted indirectly through the interventions performed during the TIPS procedure.