CardioVascular and Interventional Radiology

, Volume 20, Issue 2, pp 120–124 | Cite as

Embolization of portal-systemic shunts in cirrhotic patients with chronic recurrent hepatic encephalopathy

  • Shin Sakurabayashi
  • Shuichi Sezai
  • Yoshihiro Yamamoto
  • Masanori Hirano
  • Hiroshi Oka
Clinical Investigations



To evaluate the efficacy of embolization of portal-systemic shunts in cirrhotic patients with chronic recurrent hepatic encephalopathy (CRHE).


Seven cirrhotic patients with CRHE refractory to medical treatment (3 men and 4 women, mean age 66 years) were studied. Five patients had splenorenal shunts, 1 had a gastrorenal shunt, and 1 had an intrahepatic portal vein-hepatic vein shunt. Shunt embolization was performed using stainless steel coils, with a percutaneous transhepatic portal vein approach in 4 patients and a transrenal vein approach in 3 patients.


After embolization, the shunt disappeared in 4 patients on either ultrasound pulsed Doppler monitoring or portography. Complications observed in the 7 patients were fever, transient pleural effusion, ascites, and mild esophageal varices. For 3–6 months after embolization, the 4 patients whose shunts disappeared showed minimal or no reappearance of a shunt, and had no recurrence of encephalopathy. The serum ammonia levels decreased and electroencephalograms also improved. One of the 4 patients, who developed mild esophageal varices, required no treatment. Treatment was effective in 3 of the 4 patients (75%) who underwent embolization via a transhepatic portal vein.


Transvascular embolization of shunts improved the outcome in 4 of 7 patients. The most effective embolization was achieved via the percutaneous transhepatic portal vein approach.

Key words

Hepatic encephalopathy Liver cirrhosis Portal-systemic shunt Embolization 


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Copyright information

© Springer-Verlag New York Inc 1997

Authors and Affiliations

  • Shin Sakurabayashi
    • 1
  • Shuichi Sezai
    • 1
  • Yoshihiro Yamamoto
    • 1
  • Masanori Hirano
    • 1
  • Hiroshi Oka
    • 1
  1. 1.Division of GastroenterologyTokyo Metropolitan Police HospitalTokyoJapan

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