Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt Creation

Surbhi Trivedi; Katie Lam; Ashwin Ganesh; Yasir Hasnain; Wassim Hassan; Josi Herren; Ron C. Gaba

doi:10.1055/s-0043-1764282

Seminars in Interventional Radiology, Table of Contents

Semin intervent Radiol 2023; 40(01): 009-014
DOI: 10.1055/s-0043-1764282

Review Article

Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt Creation

Authors

Surbhi Trivedi

¹Department of Radiology, University of Illinois at Chicago College of Medicine, Chicago, Illinois

²University of Illinois at Chicago College of Medicine, Chicago, Illinois
Katie Lam^*

²University of Illinois at Chicago College of Medicine, Chicago, Illinois
Ashwin Ganesh^*

²University of Illinois at Chicago College of Medicine, Chicago, Illinois
Yasir Hasnain

²University of Illinois at Chicago College of Medicine, Chicago, Illinois
Wassim Hassan

²University of Illinois at Chicago College of Medicine, Chicago, Illinois
Josi Herren

¹Department of Radiology, University of Illinois at Chicago College of Medicine, Chicago, Illinois

²University of Illinois at Chicago College of Medicine, Chicago, Illinois
Ron C. Gaba

¹Department of Radiology, University of Illinois at Chicago College of Medicine, Chicago, Illinois

²University of Illinois at Chicago College of Medicine, Chicago, Illinois

Abstract

Transjugular intrahepatic portosystemic shunt (TIPS) creation is effective in treating the sequelae of decompensated liver cirrhosis—including medically refractory ascites and variceal bleeding—by decompressing the portal venous system through a manmade portosystemic conduit within the liver. However, the altered physiology in which splenomesenteric blood bypasses intrahepatic portal venous perfusion can precipitate varying degrees of hepatic encephalopathy (HE). While the majority of post-TIPS HE cases can be treated medically, some require escalated management strategies, including endovascular interventions to modify the indwelling TIPS and/or occlude competitive physiologic spontaneous portosystemic shunts. This review article details the epidemiology, risk factors, diagnosis, classification, and treatment of post-TIPS HE.

Keywords

interventional radiology - transjugular intrahepatic portosystemic shunt - hepatic encephalopathy - complication - embolization

Full Text

References

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