Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt Creation

作者：Surbhi B. Trivedi, Katie Lam, Ashwin Ganesh, Yasir Hasnain, Wassim A. Hassan, Josi L. Herren, Ron Charles Gaba · 发表于：Seminars in Interventional Radiology · 年份：2023 · DOI：10.1055/s-0043-1764282 · 被引用次数：9 · 研究领域：Liver Disease and Transplantation、Liver Disease Diagnosis and Treatment、Organ Transplantation Techniques and Outcomes

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.