Interventional Radiology Management of Hepatic Encephalopathy

Edward Wolfgang Lee; Justine J Liang; Griffin P McNamara

doi:10.1016/j.cld.2024.01.008

Interventional Radiology Management of Hepatic Encephalopathy

Clin Liver Dis. 2024 May;28(2):317-329. doi: 10.1016/j.cld.2024.01.008. Epub 2024 Feb 10.

Authors

Edward Wolfgang Lee¹, Justine J Liang², Griffin P McNamara³

Affiliations

¹ Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Division of Liver and Pancreas Transplant Surgery, Department of Surgery, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address: EdwardLee@mednet.ucla.edu.
² Department of Anesthesiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
³ Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

PMID: 38548442
DOI: 10.1016/j.cld.2024.01.008

Abstract

Hepatic encephalopathy (HE) is a clinically severe and devastating complication of decompensated liver disease affecting mortality, quality of life for patients and families, hospital admission rates, and overall health-care costs globally. Depending on the cause of HE, several medical treatment options have been developed and become available. In some refractory HE, such as spontaneous portosystemic shunt-related HE (SPSS-HE) or posttransjugular intrahepatic portosystemic shunt HE (post-TIPS HE), advanced interventional radiology (IR) procedures have been used, and shown to be effective in these conditions. This review presents 2 effective IR procedures for managing SPSS-HE and post-TIPS HE.

Keywords: CARTO; Hepatic encephalopathy; Retrograde transvenous obliteration; Spontaneous portosystemic shunt; TIPS occlusion; TIPS reduction; Transjugular intrahepatic portosystemic shunt.

Publication types

Review

MeSH terms

Hepatic Encephalopathy* / diagnostic imaging
Hepatic Encephalopathy* / etiology
Hepatic Encephalopathy* / therapy
Humans
Liver Cirrhosis / complications
Portasystemic Shunt, Transjugular Intrahepatic* / adverse effects
Quality of Life
Radiology, Interventional
Treatment Outcome