Acute Cerebrovascular Incident as a Complication of TIPS Procedure

Abstract

The formation of a transjugular intrahepatic portosystemic shunt (TIPS) is a well-established procedure in the management of complications of severe portal hypertension. It is also performed if portal hypertension is a result of acute portal vein thrombosis. We report the case of an acute cerebrovascular incident after TIPS formation in a patient with partial portal vein thrombosis. Even when no patent foramen ovale (PFO) is detectable the presence of PFO and thus the risk of cerebrovascular incident cannot be excluded. We therefore propose to inform patients with preexisting portal vein thrombosis prior to undergoing this intervention that TIPS procedure may be associated with the risk of cerebral embolization.

Zusammenfassung

Die Anlage eines transjugulären porto systemischen Shunts (TIPS) ist ein etabliertes Verfahren in der Behandlung der Komplikationen einer schweren portalen Hypertension. Der Eingriff wird auch durchgeführt, wenn die Ursache der portalen Hypertension eine akute Pfortaderthrombose ist. Wir berichten hier den Fall eines akuten Schlaganfalls nach TIPS-Anlage bei einem Patienten mit partieller Pfortaderthrombose. Auch wenn ein persistierendes Foramen ovale (PFO) nicht nachgewiesen wird, kann ein PFO und damit das Risiko eines Apoplexes bei Pfortaderthrombose und TIPS-Anlage nicht ausgeschlossen werden. Wir empfehlen daher, Patienten mit Pfortaderthrombose vor dem Eingriff auch über das Risiko eines möglichen Schlaganfalls aufzuklären.

Key words

esophageal varices - TIPS - ascites - PFO - acute cerebrovascular incident

Schlüsselwörter

Ösophagusvarizen - TIPS - Aszites - PFO - Schlaganfall

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