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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Author:Philipp Schindler, Hauke Heinzow, Jonel TrebickaORCiDGND, Moritz Wildgruber
Pubmed Id:
Parent Title (English):Journal of Clinical Medicine
Place of publication:Basel
Document Type:Article
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
Issue:Article 3784
Page Number:13
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0