Abstract
Transjugular intrahepatic portosystemic shunt (TIPS) occlusion is a common occurrence that can be managed based on the nature and acuity of shunt failure. Arterioportal fistulas (APFs) are rare communications between portal venous and systemic arterial vasculature that can present with symptomatic portal hypertension. In this case, we describe the management of a patient with variceal bleeding due to TIPS dysfunction complicated by the presence of an APF.