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.

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Metadaten
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:Universit├Ątsbibliothek 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:Universit├Ątspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 4.0