In this procedure the luminal diameter of the TIPSS stent is reduced, to decrease the blood flow through the stent.

After TIPSS procedure some patients may develop frequent episodes of confusion (hepatic encephalopathy) due to the toxins from the gut directly entering the main blood stream via the newly created shunt. In most patients this can be treated with medicines. Patients who fail to respond to medical therapy, are treated by reducing the diameter of the tips shunt.