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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2021; 5(02): 106-115
DOI: 10.1055/s-0041-1730869
Review Article

Endovascular Management of Hepatic Encephalopathy

Hieu Le 
1   University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, United States
,
Siddhant Thukral 
2   Department – School of Medicine, University of Missouri – Kansas City School of Medicine, Kansas City, Missouri, United States
,
A. Michael Devane 
3   University of South Carolina School of Medicine Greenville, Prisma Health, Greenville, South Carolina, United States
,
Souheil Saddekni 
4   Department of Radiology, Division of Interventional Radiology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, United States
,
Rakesh K. Varma 
4   Department of Radiology, Division of Interventional Radiology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, United States
› Author Affiliations Funding S.T. received grants from the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number TL1TR002344.
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Abstract

Transjugular intrahepatic portosystemic shunt (TIPS) and spontaneous portosystemic shunts (SPSS) may lead to new or worsening hepatic encephalopathy (HE), especially in patients with chronic liver disease. Patients with medically refractory HE (rHE) may benefit from endovascular interventions. In this review, we briefly describe the post-TIPS and SPSS vascular anatomy, pathophysiology, classification, factors associated with HE, and the medical management of HE. In addition, we will discuss current endovascular techniques for HE management, their advantages, disadvantages, and review of the current literature.

Keywords

TIPS Reduction - hepatic encephalopathy - TIPS Occlusion - spontaneous portosystemic shunt


Publication History

Article published online:
30 June 2021

© 2021. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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