Hepatic Encephalopathy After TIPS Placement: Predictive Factors, Prevention Strategies, and Management

Xin Li; Sasan Partovi; Wendy Melissa Coronado; Sameer Gadani; Charles Martin; Dustin Thompson; Abraham Levitin; Baljendra Kapoor

doi:10.1007/s00270-021-03045-3

Hepatic Encephalopathy After TIPS Placement: Predictive Factors, Prevention Strategies, and Management

Cardiovasc Intervent Radiol. 2022 May;45(5):570-577. doi: 10.1007/s00270-021-03045-3. Epub 2022 Jan 3.

Authors

Xin Li¹, Sasan Partovi², Wendy Melissa Coronado³, Sameer Gadani⁴, Charles Martin⁴, Dustin Thompson⁴, Abraham Levitin⁴, Baljendra Kapoor⁴

Affiliations

¹ Department of Radiology, Hospital of The University of Pennsylvania, Philadelphia, PA, USA.
² Section of Interventional Radiology, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, OH, USA. partovs@ccf.org.
³ Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
⁴ Section of Interventional Radiology, Imaging Institute, Cleveland Clinic Main Campus, Cleveland, OH, USA.

PMID: 34981195
DOI: 10.1007/s00270-021-03045-3

Abstract

Hepatic encephalopathy (HE) is a challenging complication after transjugular intrahepatic portosystemic shunt (TIPS) placement. Despite recent advances, much is still uncertain regarding risk factors, preventative measures, and the management of HE after TIPS placement. Appropriate patient selection and pre-procedural risk stratification remain areas of focus. In this manuscript, we discuss the current state of research related to HE after TIPS placement, including information regarding risk stratification, complication prevention, and treatment options.

Keywords: Endovascular management; Hepatic encephalopathy; TIPS.

Publication types

Review

MeSH terms

Hepatic Encephalopathy* / etiology
Hepatic Encephalopathy* / prevention & control
Humans
Liver Cirrhosis / complications
Portasystemic Shunt, Transjugular Intrahepatic* / adverse effects
Risk Factors
Treatment Outcome