Shunt-induced hepatic encephalopathy in TIPS: current approaches and clinical challenges
- Transjugular intrahepatic portosystemic shunt (TIPS) is an established treatment tool in decompensated liver cirrhosis that has been shown to prolong transplant-free survival. Hepatic encephalopathy (HE) is a frequent complication of decompensated cirrhosis, eventually induced and/or aggravated by TIPS, that remains a clinical challenge especially in these patients. Therefore, patient selection for TIPS requires careful assessment of risk factors for HE. TIPS procedural parameters regarding stent size and invasive portosystemic pressure gradient measurements thereby have an important role. Endovascular shunt modification, in combination with a conservative medical approach, often results in a significant reduction of symptoms. This review summarizes HE molecular mechanisms and pathophysiology as well as diagnostic and therapeutic approaches targeting shunt-induced HE.
| Author: | Philipp Schindler, Hauke Heinzow, Jonel TrebickaORCiDGND, Moritz Wildgruber |
|---|---|
| URN: | urn:nbn:de:hebis:30:3-574081 |
| DOI: | https://doi.org/10.3390/jcm9113784 |
| ISSN: | 2077-0383 |
| Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/33238576 |
| Parent Title (English): | Journal of Clinical Medicine |
| Publisher: | MDPI |
| Place of publication: | Basel |
| Document Type: | Article |
| Language: | English |
| Date of Publication (online): | 2020/11/23 |
| Date of first Publication: | 2020/11/23 |
| Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
| Release Date: | 2020/12/23 |
| Tag: | hepatic encephalopathy; liver cirrhosis; shunt; transjugular portosystemic intrahepatic |
| Volume: | 9 |
| Issue: | Article 3784 |
| Page Number: | 13 |
| HeBIS-PPN: | 475977793 |
| Institutes: | Medizin / Medizin |
| Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
| Sammlungen: | Universitätspublikationen |
| Licence (German): |  Creative Commons - Namensnennung 4.0 |
