Ces radiol. 2021, 75(2):141-147 | DOI: 10.55095/CesRadiol2021/016

Endovascular therapy of post TIPS hepatic encephalopathy using reducing stentgrafts - case reportCase report

Antonín Krajina1, Petr Hůlek2,3, Miroslav Lojík1, Vendelín Chovanec1, Jan Raupach1, Ondřej Renc1, Tomáš Fejfar2, Štěpán Šembera2
1 Radiologická klinika LF UK a FN, Hradec Králové
2 II. interní GE klinika LF UK a FN, Hradec Králové
3 Katedra interních oborů LF OU, Ostrava

Aim: A retrospective analysis of four cases of postTIPS hepatic encephalopathy treated by using hourglass shaped balloon expandable stentgraft implantation.

Methods: Four patients (3 men, and 1 woman of age of 50-76 years, median 63.5 years) were referred to TIPS reduction for their refractory hepatic encephalopathy. The TIPS procedures were performed for uncontrolled upper gastrointestinal bleeding (gastric varices and severe portal gastropathy) 2-48 months (median 4 months) before TIPS reduction procedure. In all patients hourglass shape balloon expandable stentgrafts were implanted from jugular approach under local anesthesia.

Results: Portosystemic gradient increased immediately after reducing stentgraft implantation from mean 7 mmHg to 18 mmHg. There was no technical complication during procedures. One patient underwent liver transplantation one year after TIPS reduction, the remaining three survived 3 years, 15, and 9 months after TIPS reduction. There was no rebleeding observed in all patients during follow up in spite of subsequent occlusion of all reduced TIPS.

Conclusion: There were alleviating of hepatic encephalopathy in all treated patients. TIPS reduction using stentgraft is an effective and simple method of treatment of refractory hepatic encephalopathy.

Keywords: TIPS, hepatic encephalopathy, portal hypertension, stentgraft
Grants and funding:

Výzkum byl podpořen Grantovou agenturou Univerzity Karlovy (SVV UK, projekt LF HK č. 260544).
The study was supported by the Charles University, project GA UK (SVV UK, LFHK, No. 260544).

Accepted: April 14, 2021; Published: June 1, 2021  Show citation

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Krajina A, Hůlek P, Lojík M, Chovanec V, Raupach J, Renc O, et al.. Endovascular therapy of post TIPS hepatic encephalopathy using reducing stentgrafts - case report. Ces radiol. 2021;75(2):141-147. doi: 10.55095/CesRadiol2021/016.
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