Final answer:
A peak systolic velocity of 216 cm/sec in a TIPS evaluated with pulsed-wave Doppler suggests TIPS stenosis, as the blood velocity would be increased in areas where the lumen is narrowed, similar to occlusions shown in Doppler-shifted images.
Step-by-step explanation:
In the context of TIPS (Transjugular Intrahepatic Portosystemic Shunt) evaluation with pulsed-wave Doppler, a peak systolic velocity in the shunt of 216 cm/sec is indicative of a TIPS stenosis. Normally, peak systolic velocities tend to be lower. Elevated peak systolic velocities suggest that the blood is forced to move faster through a narrowed segment, the situation you would expect with a stenosis or narrowing. This is similar to the Doppler-shifted images provided, where higher velocities represented in red would correlate with areas where the lumen is compromised.
While a properly functioning TIPS should have a certain range of velocities, the specific threshold for peak systolic velocity that implies stenosis can vary based on different protocols and the baseline measurements taken after TIPS placement. Given the finding of elevated systolic velocity, further evaluation for potential TIPS malfunction due to stenosis is recommended. Comparisons with baseline post-TIPS placement velocities and other aspects of the Doppler study will provide a comprehensive assessment of the TIPS function.