Patients with end stage liver disease/cirrhosis often develop either bleeding from varices or ascites (fluid) in the abdomen which requires frequent drainage. These complications result from scarring in the liver which prevents or severely limits antegrade flow in the portal vein. This resulting “backup” of flow lead to the complications noted above. In appropriately selected patients, placing a TIPS can eliminate bleeding and reduce or eliminate the need for ascites drainage. The procedure is performed from the neck and the Interventional Radiologist carefully advances a needle from the vein that drains the liver into the portal vein. This procedure decompresses the liver. Patients are admitted the night following TIPS placement and followed closely thereafter with regular screening ultrasound studies performed to ensure that the shunt is working properly. When needed, repairs or revisions can be done as an outpatient procedure.