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BackTable / VI / Podcast / Episode #330

Early Days and Evolution of the TIPS Procedure

with Dr. Richard Saxon

In this episode, guest host Dr. Isabel Newton interviews Dr. Richard Saxon about his innovative approach of using stent grafts for transjugular intrahepatic portosystemic shunting (TIPS), the creation of the Viatorr endoprosthesis, and medical ethics of experimental technology.

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Early Days and Evolution of the TIPS Procedure with Dr. Richard Saxon on the BackTable VI Podcast)
Ep 330 Early Days and Evolution of the TIPS Procedure with Dr. Richard Saxon
00:00 / 01:04

BackTable, LLC (Producer). (2023, June 9). Ep. 330 – Early Days and Evolution of the TIPS Procedure [Audio podcast]. Retrieved from

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Podcast Contributors

Dr. Richard Saxon discusses Early Days and Evolution of the TIPS Procedure on the BackTable 330 Podcast

Dr. Richard Saxon

Dr. Richard Saxon is an interventional radiologist with Tri-City Medical Center and Palomar Health in San Diego, California.

Dr. Isabel Newton discusses Early Days and Evolution of the TIPS Procedure on the BackTable 330 Podcast

Dr. Isabel Newton

Dr. Isabel Newton is a practicing interventional radiologist at UC San Diego Health in San Diego, CA.


As an IR fellow, Dr. Saxon was surrounded by constant innovation at the Dotter Institute. He saw the takeoff of TIPS as a last treatment option for patients with liver failure, who were suffering from major variceal bleeding. He recounts the early days of TIPS as extremely technically challenging and arduous, since the methods and devices had not yet been refined. Dr. Saxon spent a significant amount of time performing TIPS revision procedures, which led him to explore the underlying pathology of biliary duct injury and subsequent stent thrombosis. These experiences led him to develop a stent graft for TIPS, which was first tested in swine models and eventually became the Viatorr endoprosthesis. Dr. Saxon highlights the supportive people and environment at the Dotter Institute as a major factor in fueling TIPS improvement. Additionally, during this era, innovative ideas were able to flourish with less influence of medical-legal or intellectual property disputes.

In today’s clinical setting, TIPS has become a good option for patients with intractable variceal bleeding, but it is no longer the only option. Dr. Newton emphasizes that patient selection is a crucial part of ensuring that IRs continue to practice safely and effectively. The doctors discuss hepatic encephalopathy, another complication of TIPS that requires careful patient screening, adequate follow up, and collaboration with the medicine side of liver disease treatment.

Finally, Dr. Saxon reflects on his career in translational research. A large part of his success has come from recognizing where his passions lie, what his current work environment can support, and maintaining a constant drive to improve procedures and clinical care.


Gore Viatorr TIPS Endoprosthesis:

Stent-Grafts for Revision of TIPS Stenoses and Occlusions: A Clinical Pilot Study:

Barry Uchida on the BackTable Podcast:

Disclaimer: The Materials available on are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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TIPS Procedure Steps & Technique

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