Digestive Disease Interventions 2019; 03(S 01): S1-S15
DOI: 10.1055/s-0039-1679912
Oral Presentations
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA

Predictors and Management of Hepatic Encephalopathy in Patients with Transjugular Intrahepatic Portosystemic Shunt

Connie Ju
1   Case Western Reserve University School of Medicine, Cleveland, Ohio
,
Wendy Melissa Coronado
2   Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
,
Baljendra Kapoor
3   Cleveland Clinic Imaging Institute, Cleveland, Ohio
› Author Affiliations
Further Information

Publication History

Publication Date:
03 May 2019 (online)

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    Introduction: Portosystemic encephalopathy (PSE) is a well-known sequela of transjugular intrahepatic portosystemic shunt (TIPS) placement due to increased delivery of neurotoxins from the portal to systemic circulation. Many studies have described clinical and laboratory prognosticators, though their reliability in predicting PSE remains to be determined. When encephalopathy becomes refractory to medical management, radiointerventional techniques to achieve shunt occlusion or reduction can be employed. This educational exhibit consolidates commonly cited predictors, medical management strategies, and interventional management techniques for post-TIPS encephalopathy.

    Content Organization:

    1. Discuss clinical and laboratory predictors of PSE.

    2. Medical management strategies and underlying pathophysiology of PSE.

    3. Evolution of interventional radiology techniques and their limitations: shunt occlusion and shunt reduction.

    Learning Points: PSE is a well-known complication following TIPS insertion, and numerous clinical and laboratory predictors have been proposed. Several endovascular strategies with varying limitations and degrees of technical difficulty are available for interventionalists treating post-TIPS encephalopathy.


     

    No conflict of interest has been declared by the author(s).