Tract in a Patient with Hepatic Encephalopathy

A novel endovascular technique to reduce flow through a transjugular intrahepatic portosystemic shunt (TIPS) is described in a patient with severe hepatic encephalopathy. This technique allows controlled and potentially adjust-able partial closure of the TIPS without thromboembolic risk. The patient experienced a dramatic clinical improve-ment after the procedure. J Vasc Interv Radiol 2006; 17:1957–1961 Abbreviations: HE hepatic encephalopathy, TIPS transjugular intrahepatic portosystemic shunt HEPATIC encephalopathy (HE) is the most common complication of porto-systemic shunt creation, including transjugular intrahepatic portosys-temic shunt (TIPS) procedures. The re-ported incidences of new or worsen-ing HE after a TIPS procedure range from 5 % to 35 % (1). Medical manage-ment of TIPS-induced HE include