Skip to main content
SpringerLink
Log in

Prevention of post-tips hepatic encephalopathy: The search of the ideal candidate

  • Review Article
  • Published:
Metabolic Brain Disease Aims and scope Submit manuscript

Abstract

Transjugular intrahepatic portosystemic shunt (TIPS) has been used since more than 25 years to treat some of the complications of portal hypertension, especially variceal bleeding and ascites refractory to conventional therapy. TIPS establishes a communication between the portal and hepatic veins, inducing the blood to shift from the splanchnic circulation into the systemic vascular bed with the aim of decompressing the portal venous system, and avoids the major complications of portal hypertension. However, the shunt of the portal blood into the systemic circulation is the cause of one of the major complications of the procedure: the post-TIPS hepatic encephalopathy (HE). To date, few pharmacological treatment has been proven effective to prevent this complication and thus, the identification of patients at high risk of post-TIPS hepatic encephalopathy and the patients’ carefully selection is the only way to prevent this frequent complication.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

Not Applicable.

Code availability

Not Applicable.

References

  • Adlakha N, Russo MW (2020) Outcomes After Transjugular Intrahepatic Portosystemic Shunt in Cirrhotic Patients 70 Years and Older. J Clin Med 9. https://doi.org/10.3390/jcm9020381

  • Bai M, Qi X, Yang Z, Yin Z, Nie Y, Yuan S, Wu K, Han G, Fan D (2011) Predictors of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in cirrhotic patients: a systematic review. J Gastroenterol Hepatol 26(6):943–951. https://doi.org/10.1111/j.1440-1746.2011.06663.x

    Article  PubMed  Google Scholar 

  • Bass NM, Mullen KD, Sanyal A et al (2010) Rifaximin treatment in hepatic encephalopathy. N Engl J Med 362:1071–1081

    Article  CAS  PubMed  Google Scholar 

  • Berlioux P, Robic MA, Poirson H, Métivier S, Otal P, Barret C, Lopez F, Péron JM, Vinel JP, Bureau C (2014) Pre-transjugular intrahepatic portosystemic shunts (TIPS) prediction of post-TIPS overt hepatic encephalopathy: the critical flicker frequency is more accurate than psychometric tests. Hepatology 59(2):622–629. https://doi.org/10.1002/hep.26684

    Article  PubMed  Google Scholar 

  • Bhanji RA, Moctezuma-Velazquez C, Duarte-Rojo A, Ebadi M, Ghosh S, Rose C, Montano-Loza AJ (2018) Myosteatosis and sarcopenia are associated with hepatic encephalopathy in patients with cirrhosis. Hepatol Int 12(4):377–386. https://doi.org/10.1007/s12072-018-9875-9

    Article  PubMed  Google Scholar 

  • Boyer TD, Haskal ZJ (2010) The role of transjugular intrahepatic portosystemic shunt (TIPS) in the management of portal hypertension: update 2009. Hepatology 51:306

    Article  PubMed  Google Scholar 

  • Bureau C, Garcia-Pagan JC, Otal P, Pomier-Layrargues G, Chabbert V, Cortez C, Perreault P, Péron JM, Abraldes JG, Bouchard L, Bilbao JI, Bosch J, Rousseau H, Vinel JP (2004) Improved clinical outcome using polytetrafluoroethylene-coated stents for TIPS: results of a randomized study. Gastroenterology 126(2):469–475. https://doi.org/10.1053/j.gastro.2003.11.016

    Article  PubMed  Google Scholar 

  • Bureau C, Thabut D, Oberti F, Dharancy S, Carbonell N, Bouvier A, Mathurin P, Otal P, Cabarrou P, Péron JM, Vinel JP (2017) Transjugular Intrahepatic Portosystemic Shunts With Covered Stents Increase Transplant-Free Survival of Patients With Cirrhosis and Recurrent Ascites. Gastroenterology 152(1):157–163

    Article  PubMed  Google Scholar 

  • Bureau C, Thabut D, Jezequel C, Archambeaud I, D’Alteroche L, Dharancy S, Borentain P, Oberti F, Plessier A, De Ledinghen V, Ganne-Carrié N, Carbonell N, Rousseau V, Sommet A, Péron JM, Vinel JP (2021) The Use of Rifaximin in the Prevention of Overt Hepatic Encephalopathy After Transjugular Intrahepatic Portosystemic Shunt : A Randomized Controlled Trial. Ann Intern Med 174(5):633–640. https://doi.org/10.7326/M20-0202

    Article  PubMed  Google Scholar 

  • Cabrera J, Maynar M, Granados R, Gorriz E, Reyes R, Pulido-Duque JM, Rodriguez SanRoman JL, Guerra C, Kravetz D (1996) Transjugular intrahepatic portosystemic shunt versus sclerotherapy in the elective treatment of variceal hemorrhage. Gastroenterology 110(3):832–839

    Article  CAS  PubMed  Google Scholar 

  • Casado M, Bosch J, García-Pagán JC, Bru C, Bañares R, Bandi JC, Escorsell A, Rodríguez-Láiz JM, Gilabert R, Feu F, Schorlemer C, Echenagusia A, Rodés J (1998) Clinical events after transjugular intrahepatic portosystemic shunt: correlation with hemodynamic findings. Gastroenterology 114:1296–1303

    Article  CAS  PubMed  Google Scholar 

  • Cello JP, Ring EJ, Olcott EW, Koch J, Gordon R, Sandhu J, Morgan DR, Ostroff JW, Rockey DC, Bacchetti P, LaBerge J, Lake JR, Somberg K, Doherty C, Davila M, McQuaid K, Wall SD (1997) Endoscopic sclerotherapy compared with percutaneous transjugular intrahepatic portosystemic shunt after initial sclerotherapy in patients with acute variceal hemorrhage. A randomized, controlled trial. Ann Intern Med 126(11):858–65

  • Coronado WM, Ju C, Bullen J, Kapoor B (2020) Predictors of Occurrence and Risk of Hepatic Encephalopathy After TIPS Creation: A 15-Year Experience. Cardiovasc Intervent Radiol 43(8):1156–1164. https://doi.org/10.1007/s00270-020-02512-7

    Article  PubMed  Google Scholar 

  • Coronado WM, Ju C, Bullen J, Kapoor B (2020) Predictors of Occurrence and Risk of Hepatic Encephalopathy After TIPS Creation: A 15-Year Experience. Cardiovasc Intervent Radiol 43:1156–1164. https://doi.org/10.1007/s00270-020-02512-7

  • Dam G, Vilstrup H, Watson H, Jepsen P (2016) Proton pump inhibitors as a risk factor for hepatic encephalopathy and spontaneous bacterial peritonitis in patients with cirrhosis with ascites. Hepatology 64(4):1265–1272. https://doi.org/10.1002/hep.28737

    Article  CAS  PubMed  Google Scholar 

  • de Franchis R, Bosch J, Garcia-Tsao G, Reiberger T, Ripoll C, Baveno VII Faculty (2022) Baveno VII - Renewing consensus in portal hypertension. J Hepatol 76(4):959–974. https://doi.org/10.1016/j.jhep.2021.12.022 Erratum in: J Hepatol. 2022 Apr 14

  • de Wit K, Schaapman JJ, Nevens F, Verbeek J, Coenen S, Cuperus FJC, Kramer M, Tjwa ETTL, Mostafavi N, Dijkgraaf MGW, van Delden OM, Beuers UHW, Coenraad MJ, Takkenberg RB (2020) Prevention of hepatic encephalopathy by administration of rifaximin and lactulose in patients with liver cirrhosis undergoing placement of a transjugular intrahepatic portosystemic shunt (TIPS): a multicentre randomised, double blind, placebo controlled trial (PEARL trial). BMJ Open Gastroenterol 7(1):e000531

    Article  PubMed  PubMed Central  Google Scholar 

  • DeGasperi A, Corti A, Corso R et al (2009) Transjugular intrahepatic portosystemic shunt (TIPS): the anesthesiological point of view after 150 procedures managed under total intravenous anesthesia. J Clin Monit Comput 23:341–346

    Article  PubMed  Google Scholar 

  • Di Cola S, Nardelli S, Ridola L, Gioia S, Riggio O, Merli M (2022) Ammonia and the Muscle: An Emerging Point of View on Hepatic Encephalopathy. J Clin Med 11(3):611. https://doi.org/10.3390/jcm11030611

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • European Association for the Study of the Liver (2022) Electronic address: easloffice@easloffice.eu; European Association for the Study of the Liver. EASL Clinical Practice Guidelines on the management of hepatic encephalopathy. J Hepatol 77(3):807–824

  • Escorsell A, Bañares R, García-Pagán JC, Gilabert R, Moitinho E, Piqueras B, Bru C, Echenagusia A, Granados A, Bosch J (2002) TIPS versus drug therapy in preventing variceal rebleeding in advanced cirrhosis: a randomized controlled trial. Hepatology 35(2):385–392

    Article  PubMed  Google Scholar 

  • García-Pagán JC, Caca K, Bureau C, Laleman W, Appenrodt B, Luca A, Abraldes JG, Nevens F, Vinel JP, Mössner J, Bosch J, Early TIPS (Transjugular Intrahepatic Portosystemic Shunt) Cooperative Study Group (2010) Early use of TIPS in patients with cirrhosis and variceal bleeding. N Engl J Med 362(25):2370–9

  • Gioia S, Merli M, Nardelli S, Lattanzi B, Pitocchi F, Ridola L, Riggio O (2019) The modification of quantity and quality of muscle mass improves the cognitive impairment after TIPS. Liver Int 39(5):871–877. https://doi.org/10.1111/liv.14050

    Article  PubMed  Google Scholar 

  • Gioia S, Ridola L, Cristofaro L, Merli M, Faccioli J, Riggio O, Nardelli S (2021) The improvement in body composition including subcutaneous and visceral fat reduces ammonia and hepatic encephalopathy after transjugular intrahepatic portosystemic shunt. Liver Int 41(12):2965–2973. https://doi.org/10.1111/liv.15060

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ginès P, Uriz J, Calahorra B, Garcia-Tsao G, Kamath PS, Del Arbol LR, Planas R, Bosch J, Arroyo V, Rodés J (2002) Transjugular intrahepatic portosystemic shunting versus paracentesis plus albumin for refractory ascites in cirrhosis. Gastroenterology 123(6):1839–1847

    Article  PubMed  Google Scholar 

  • Gülberg V, Schepke M, Geigenberger G, Holl J, Brensing KA, Waggershauser T, Reiser M, Schild HH, Sauerbruch T, Gerbes AL (2002) Transjugular intrahepatic portosystemic shunting is not superior to endoscopic variceal band ligation for prevention of variceal rebleeding in cirrhotic patients: a randomized, controlled trial. Scand J Gastroenterol 37(3):338–343

    Article  PubMed  Google Scholar 

  • Huang Z, Yao Q, Zhu J, He Y, Chen Y, Wu F, Hua T (2021) Efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) created using covered stents of different diameters: A systematic review and meta-analysis. Diagn Interv Imaging 102(5):279–285. https://doi.org/10.1016/j.diii.2020.11.004

    Article  PubMed  Google Scholar 

  • Jalan R, Forrest EH, Stanley AJ, Redhead DN, Forbes J, Dillon JF, MacGilchrist AJ, Finlayson ND, Hayes PC (1997) A randomized trial comparing transjugular intrahepatic portosystemic stent-shunt with variceal band ligation in the prevention of rebleeding from esophageal varices. Hepatology 26(5):1115–1122

    CAS  PubMed  Google Scholar 

  • Lebrec D, Giuily N, Hadengue A, Vilgrain V, Moreau R, Poynard T, Gadano A, Lassen C, Benhamou JP, Erlinger S (1996) Transjugular intrahepatic portosystemic shunts: comparison with paracentesis in patients with cirrhosis and refractory ascites: a randomized trial. French Group of Clinicians and a Group of Biologists. J Hepatol 25(2):135–44

  • Lewis DS, Lee TH, Konanur M, Ziegler C, Hall MD, Pabon-Ramos WM, Suhocki PV, Smith TP, Kim CY, Choi SS, Ronald J (2019) Proton Pump Inhibitor Use Is Associated with an Increased Frequency of New or Worsening Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt Creation. J Vasc Interv Radiol 30(2):163–169. https://doi.org/10.1016/j.jvir.2018.10.015

    Article  PubMed  Google Scholar 

  • Lo GH, Liang HL, Chen WC, Chen MH, Lai KH, Hsu PI, Lin CK, Chan HH, Pan HB (2007) A prospective, randomized controlled trial of transjugular intrahepatic portosystemic shunt versus cyanoacrylate injection in the prevention of gastric variceal rebleeding. Endoscopy 39(8):679–685

    Article  PubMed  Google Scholar 

  • Lv Y, Chen H, Luo B, Bai W, Li K, Wang Z, Xia D, Guo W, Wang Q, Li X, Yuan J, Cai H, Xia J, Yin Z, Fan D, Han G (2019) Concurrent large spontaneous portosystemic shunt embolization for the prevention of overt hepatic encephalopathy after TIPS: A randomized controlled trial. Hepatology 76(3):676–688

  • Lv Y, Qi X, He C, Wang Z, Yin Z, Niu J, Guo W, Bai W, Zhang H, Xie H, Yao L, Wang J, Li T, Wang Q, Chen H, Liu H, Wang E, Xia D, Luo B, Li X, Yuan J, Han N, Zhu Y, Xia J, Cai H, Yang Z, Wu K, Fan D, Han G, PVT-TIPS Study Group (2018) Covered TIPS versus endoscopic band ligation plus propranolol for the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis: a randomised controlled trial. Gut 67(12):2156–2168

  • Mamiya Y, Kanazawa H, Kimura Y et al (2004) Hepatic encephalopathy after transjugular intrahepatic portosystemic shunt. Hepatol Res 30:162–168

    Article  PubMed  Google Scholar 

  • Merli M, Giusto M, Lucidi C, Giannelli V, Pentassuglio I, Di Gregorio V, Lattanzi B, Riggio O (2013) Muscle depletion increases the risk of overt and minimal hepatic encephalopathy: results of a prospective study. Metab Brain Dis 28(2):281–284. https://doi.org/10.1007/s11011-012-9365-z

    Article  CAS  PubMed  Google Scholar 

  • Merli M, Riggio O, Dally L (1996) Does malnutrition affect survival in cirrhosis? PINC (Policentrica Italiana Nutrizione Cirrosi). Hepatology 23(5):1041–1046. https://doi.org/10.1002/hep.510230516

    Article  CAS  PubMed  Google Scholar 

  • Merli M, Salerno F, Riggio O, de Franchis R, Fiaccadori F, Meddi P, Primignani M, Pedretti G, Maggi A, Capocaccia L, Lovaria A, Ugolotti U, Salvatori F, Bezzi M, Rossi P (1998) Transjugular intrahepatic portosystemic shunt versus endoscopic sclerotherapy for the prevention of variceal bleeding in cirrhosis: a randomized multicenter trial. Gruppo Italiano Studio TIPS (G.I.S.T.). Hepatology 27(1):48–53

  • Miraglia R, Maruzzelli L, Di Piazza A, Mamone G, Caruso S, Gentile G, Tuzzolino F, Floridia G, Petridis I, Volpes R, Luca A (2019) Transjugular Intrahepatic Portosystemic Shunt Using the New Gore Viatorr Controlled Expansion Endoprosthesis: Prospective, Single-Center, Preliminary Experience. Cardiovasc Intervent Radiol 42:78–86. https://doi.org/10.1007/s00270-018-2040-y

  • Mollaiyan A, Bettinger D, Rössle M (2017) The underdilation of nitinol stents at TIPS implantation: Solution or illusion? Eur J Radiol 89:123–128. https://doi.org/10.1016/j.ejrad.2017.01.032

    Article  PubMed  Google Scholar 

  • Montagnese S, Russo FP, Amodio P, Burra P, Gasbarrini A, Loguercio C, Marchesini G, Merli M, Ponziani FR, Riggio O, Scarpignato C (2019) Hepatic encephalopathy 2018: A clinical practice guideline by the Italian Association for the Study of the Liver (AISF). Dig Liver Dis 51(2):190–205. https://doi.org/10.1016/j.dld.2018.11.035

    Article  PubMed  Google Scholar 

  • Montano-Loza AJ, Angulo P, Meza-Junco J, Prado CM, Sawyer MB, Beaumont C, Esfandiari N, Ma M, Baracos VE (2016) Sarcopenic obesity and myosteatosis are associated with higher mortality in patients with cirrhosis. J Cachexia Sarcopenia Muscle 7(2):126–35. https://doi.org/10.1002/jcsm.12039

  • Montano-Loza AJ, Meza-Junco J, Prado CM, Lieffers JR, Baracos VE, Bain VG, Sawyer MB (2012) Muscle wasting is associated with mortality in patients with cirrhosis. Clin Gastroenterol Hepatol 10(2):166–73, 173.e1. https://doi.org/10.1016/j.cgh.2011.08.028

  • Narahara Y, Kanazawa H, Fukuda T, Matsushita Y, Harimoto H, Kidokoro H, Katakura T, Atsukawa M, Taki Y, Kimura Y, Nakatsuka K, Sakamoto C (2011) Transjugular intrahepatic portosystemic shunt versus paracentesis plus albumin in patients with refractory ascites who have good hepatic and renal function: a prospective randomized trial. J Gastroenterol 46(1):78–85

    Article  CAS  PubMed  Google Scholar 

  • Nardelli S, Gioia S, Pasquale C, Pentassuglio I, Farcomeni A, Merli M, Salvatori FM, Nikolli L, Torrisi S, Greco F, Nicoletti V, Riggio O (2016) Cognitive Impairment Predicts The Occurrence Of Hepatic Encephalopathy After Transjugular Intrahepatic Portosystemic Shunt. Am J Gastroenterol 111(4):523–528. https://doi.org/10.1038/ajg.2016.29

    Article  PubMed  Google Scholar 

  • Nardelli S, Gioia S, Ridola L, Farcomeni A, Merli M, Riggio O (2019) Proton Pump Inhibitors Are Associated With Minimal and Overt Hepatic Encephalopathy and Increased Mortality in Patients With Cirrhosis. Hepatology 70(2):640–649. https://doi.org/10.1002/hep.30304

    Article  CAS  PubMed  Google Scholar 

  • Nardelli S, Lattanzi B, Merli M, Farcomeni A, Gioia S, Ridola L, Riggio O (2019) Muscle Alterations Are Associated With Minimal and Overt Hepatic Encephalopathy in Patients With Liver Cirrhosis. Hepatology 70(5):1704–1713. https://doi.org/10.1002/hep.30692

    Article  PubMed  Google Scholar 

  • Nardelli S, Lattanzi B, Torrisi S, Greco F, Farcomeni A, Gioia S, Merli M, Riggio O (2017) Sarcopenia Is Risk Factor for Development of Hepatic Encephalopathy After Transjugular Intrahepatic Portosystemic Shunt Placement. Clin Gastroenterol Hepatol 15(6):934–936. https://doi.org/10.1016/j.cgh.2016.10.028

    Article  PubMed  Google Scholar 

  • Plauth M, Merli M, Kondrup J, Weimann A, Ferenci P, Müller MJ; ESPEN Consensus Group (1997) ESPEN guidelines for nutrition in liver disease and transplantation. Clin Nutr 16(2):43–55. https://doi.org/10.1016/s0261-5614(97)80022-2

  • Pomier-Layrargues G, Villeneuve JP, Deschênes M, Bui B, Perreault P, Fenyves D, Willems B, Marleau D, Bilodeau M, Lafortune M, Dufresne MP (2001) Transjugular intrahepatic portosystemic shunt (TIPS) versus endoscopic variceal ligation in the prevention of variceal rebleeding in patients with cirrhosis: a randomised trial. Gut 48(3):390–396

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Praktiknjo M, Lehmann J, Fischer S, Strassburg CP, Meyer C, Trebicka J (2017) Novel diameter controlled expansion TIPS (Viatorr CX®) graft reduces readmission compared to regular covered TIPS graft and bare metal graft. J Hepatol 66:S48–S49. https://doi.org/10.1016/S0168-8278(17)30360-4

    Article  Google Scholar 

  • Riggio O, Angeloni S, Salvatori FM, De Santis A, Cerini F, Farcomeni A, Attili AF, Merli M (2008) Incidence, natural history, and risk factors of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt with polytetrafluoroethylene-covered stent grafts. Am J Gastroenterol 103(11):2738–2746. https://doi.org/10.1111/j.1572-0241.2008.02102.x

    Article  PubMed  Google Scholar 

  • Riggio O, Masini A, Efrati C et al (2005) Pharmacological prophylaxis of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt: a randomized controlled study. J Hepatol 42:674–679

    Article  CAS  PubMed  Google Scholar 

  • Riggio O, Merli M, Pedretti R et al (1996) Hepatic encephalopathy after transjugular intrahepatic portosystemic shunt. Incidence and risk factors. Dig Dis Sci 41:578–84

  • Riggio O, Nardelli S, Moscucci F, Pasquale C, Ridola L, Merli M (2012) Hepatic encephalopathy after transjugular intrahepatic portosystemic shunt. Clin Liver Dis 16(1):133–146

    Article  PubMed  Google Scholar 

  • Riggio O, Ridola L, Angeloni S, Cerini F, Pasquale C, Attili AF, Fanelli F, Merli M, Salvatori FM (2010) Clinical efficacy of transjugular intrahepatic portosystemic shunt created with covered stents with different diameters: results of a randomized controlled trial. J Hepatol 53(2):267–272. https://doi.org/10.1016/j.jhep.2010.02.033

    Article  PubMed  Google Scholar 

  • Riggio O, Ridola L, Lucidi C et al (2010) Emerging issues in the use of transjugular in- trahepatic portosystemic shunt (TIPS) for management of portal hypertension: time to update the guidelines? Dig Liver Dis 42:462–467

    Article  PubMed  Google Scholar 

  • Rikkers L, Jenko P, Rudman D et al (1978) Subclinical hepatic encephalopathy: detection, prevalence, and relationship to nitrogen metabolism. Gastroenterology 75:462–469

    Article  CAS  PubMed  Google Scholar 

  • Rösch J, Keller FS (2001) Transjugular intrahepatic portosystemic shunt: present status, comparison with endoscopic therapy and shunt surgery, and future prospectives. World J Surg 25:337–46

  • Rossle M, Richter GM, Noldge G et al (1989) New non-operative treatment for variceal haemorrhage. Lancet 2:153

    Article  CAS  PubMed  Google Scholar 

  • Rössle M, Deibert P, Haag K, Ochs A, Olschewski M, Siegerstetter V, Hauenstein KH, Geiger R, Stiepak C, Keller W, Blum HE (1997) Randomised trial of transjugular-intrahepatic-portosystemic shunt versus endoscopy plus propranolol for prevention of variceal rebleeding. Lancet 349(9058):1043–1049

    Article  PubMed  Google Scholar 

  • Rössle M, Ochs A, Gülberg V, Siegerstetter V, Holl J, Deibert P, Olschewski M, Reiser M, Gerbes AL (2000) A comparison of paracentesis and transjugular intrahepatic portosystemic shunting in patients with ascites. N Engl J Med 342(23):1701–1707

    Article  PubMed  Google Scholar 

  • Rössle M, Siegerstetter V, Euringer W, Olschewski M, Kromeier J, Kurz K, Langer M (2006) The use of a polytetrafluoroethylene-covered stent graft for transjugular intrahepatic portosystemic shunt (TIPS): Long-term follow-up of 100 patients. Acta Radiol 47(7):660–666

    Article  PubMed  Google Scholar 

  • Saad N, Rude MK, Darcy M, Hanin JB, Wentworth A, Korenblat KM (2016) Older age is associated with increased early mortality after transjugular intrahepatic portosystemic shunt. Ann Hepatol 15:215–221

    PubMed  Google Scholar 

  • Salerno F, Merli M, Riggio O, Cazzaniga M, Valeriano V, Pozzi M, Nicolini A, Salvatori F (2004) Randomized controlled study of TIPS versus paracentesis plus albumin in cirrhosis with severe ascites. Hepatology 40(3):629–635

    Article  CAS  PubMed  Google Scholar 

  • Sanjal AJ, Freedman A, Shiffman ML et al (1994) Portosystemic encephalopathy after transjugular intrahepatic portosystemic shunt: results of a prospective controlled study. Hepatology 20:46–55

    Google Scholar 

  • Sanyal AJ, Freedman AM, Luketic VA, Purdum PP 3rd, Shiffman ML, Cole PE, Tisnado J, Simmons S (1997) Transjugular intrahepatic portosystemic shunts compared with endoscopic sclerotherapy for the prevention of recurrent variceal hemorrhage. A randomized, controlled trial. Ann Intern Med 126(11):849–57

  • Sanyal AJ, Genning C, Reddy KR, Wong F, Kowdley KV, Benner K, McCashland T, North American Study for the Treatment of Refractory Ascites Group (2003) The North American Study for the Treatment of Refractory Ascites. Gastroenterology 124(3):634–41

  • Sauer P, Theilmann L, Stremmel W, Benz C, Richter GM, Stiehl A (1997) Transjugular intrahepatic portosystemic stent shunt versus sclerotherapy plus propranolol for variceal rebleeding. Gastroenterology 113(5):1623–1631

    Article  CAS  PubMed  Google Scholar 

  • Sauer P, Hansmann J, Richter GM, Stremmel W, Stiehl A (2002) Endoscopic variceal ligation plus propranolol vs. transjugular intrahepatic portosystemic stent shunt: a long-term randomized trial. Endoscopy 34(9):690–7

  • Schindler P, Seifert L, Masthoff M, Riegel A, Köhler M, Wilms C, Schmidt HH, Heinzow H, Wildgruber M (2020) TIPS Modification in the Management of Shunt-Induced Hepatic Encephalopathy: Analysis of Predictive Factors and Outcome with Shunt Modification. J Clin Med 9(2):567. https://doi.org/10.3390/jcm9020567

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Shiffman ML, Jeffers L, Hoofnagle JH, et al (1995) Role of transjugular intrahepatic portosystemic shunt treatment of portal hypertension and its complication: conference sponsored by the National Digestive Diseases Advisory Board. Hepatology 22:1591–7

  • Somberg KA, Riegler JL, LaBerge JM et al (1995) Hepatic encephalopathy after trans- jugular intrahepatic portosystemic shunt: incidence and risk factors. Am J Gas- Troenterol 90:549–555

    CAS  Google Scholar 

  • Tantai X, Liu Y, Yeo YH, Praktiknjo M, Mauro E, Hamaguchi Y, Engelmann C, Zhang P, Jeong JY, van Vugt JLA, Xiao H, Deng H, Gao X, Ye Q, Zhang J, Yang L, Cai Y, Liu Y, Liu N, Li Z, Han T, Kaido T, Sohn JH, Strassburg C, Berg T, Trebicka J, Hsu YC, IJzermans JNM, Wang J, Su GL, Ji F, Nguyen MH (2022) Effect of sarcopenia on survival in patients with cirrhosis: A meta-analysis. J Hepatol 76(3):588–599

  • Trebicka J, Bastgen D, Byrtus J, Praktiknjo M, Terstiegen S, Meyer C, Thomas D, Fimmers R, Treitl M, Euringer W, Sauerbruch T, Rössle M (2019) Smaller-Diameter Covered Transjugular Intrahepatic Portosystemic Shunt Stents Are Associated With Increased Survival. Clin Gastroenterol Hepatol 17(13):2793-2799.e1. https://doi.org/10.1016/j.cgh.2019.03.042

    Article  PubMed  Google Scholar 

  • Tripathi D, Stanley AJ, Hayes PC, Travis S, Armstrong MJ, Tsochatzis EA, Rowe IA, Roslund N, Ireland H, Lomax M, Leithead JA, Mehrzad H, Aspinall RJ, McDonagh J, Patch D (2020) Transjugular intrahepatic portosystemic stent-shunt in the management of portal hypertension. Gut 69(7):1173–1192. https://doi.org/10.1136/gutjnl-2019-320221

  • Tsai CF, Chen MH, Wang YP, Chu CJ, Huang YH, Lin HC, Hou MC, Lee FY, Su TP, Lu CL (2017) Proton Pump Inhibitors Increase Risk for Hepatic Encephalopathy in Patients With Cirrhosis in A Population Study. Gastroenterology 152(1):134–141. https://doi.org/10.1053/j.gastro.2016.09.007

    Article  CAS  PubMed  Google Scholar 

  • Vignali C, Bargellini I, Grosso M, Passalacqua G, Maglione F, Pedrazzini F, Filauri P, Niola R, Cioni R, Petruzzi P (2005) TIPS with expanded polytetrafluoroethylene-covered stent: results of an Italian multicenter study. AJR Am J Roentgenol 185(2):472–480

    Article  PubMed  Google Scholar 

  • Wang L, Xiao Z, Yue Z, Zhao H, Fan Z, Zhao M, He F, Dai S, Qiu B, Yao J, Lin Q, Dong X, Liu F (2016) Efficacy of covered and bare stent in TIPS for cirrhotic portal hypertension: A single-center randomized trial. Sci Rep 15(6):21011

    Article  Google Scholar 

  • Wang Q, Lv Y, Bai M, Wang Z, Liu H, He C, Niu J, Guo W, Luo B, Yin Z, Bai W, Chen H, Wang E, Xia D, Li X, Yuan J, Han N, Cai H, Li T, Xie H, Xia J, Wang J, Zhang H, Wu K, Fan D, Han G (2017) Eight millimetre covered TIPS does not compromise shunt function but reduces hepatic encephalopathy in preventing variceal rebleeding. J Hepatol 67(3):508–516. https://doi.org/10.1016/j.jhep.2017.05.006

    Article  PubMed  Google Scholar 

  • Wong F, Sniderman K, Liu P et al (1997) The mechanism of the initial natriuresis after transjugular intrahepatic portosystemic shunt. Gastroenterology 112:899–907

    Article  CAS  PubMed  Google Scholar 

  • Yao J, Zuo L, An G, Yue Z, Zhao H, Wang L, Liu F (2015) Risk Factors for Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt in Patients with Hepatocellular Carcinoma and Portal Hypertension. J Gastrointestin Liver Dis 24(3):301–307. https://doi.org/10.15403/jgld.2014.1121.243.yao

    Article  PubMed  Google Scholar 

  • Yin X, Zhang F, Guo H, Peng C, Zhang W, Xiao J, Wang Y, Zou X, Zhang M, Zhuge Y (2020) A nomogram to predict the risk of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in Cirrhotic Patients. Sci Rep 10(1):9381. https://doi.org/10.1038/s41598-020-65227-2

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Zuckerman DA, Darcy MD, Bocchini TP, Hildebolt CF (1997) Encephalopathy after transjugular intrahepatic portosystemic shunting: analysis of incidence and potential risk factors. AJR Am J Roentgenol 169:1727–1731. https://doi.org/10.2214/ajr.169.6

Download references

Author information

Authors and Affiliations

  1. Department of Translational and Precision Medicine, “Sapienza” University of Rome, Viale Dell’Università 37, Rome, Italy

    Silvia Nardelli, Daniele Bellafante, Lorenzo Ridola, Jessica Faccioli, Oliviero Riggio & Stefania Gioia

Authors
  1. Silvia Nardelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniele Bellafante
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lorenzo Ridola
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jessica Faccioli
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Oliviero Riggio
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Stefania Gioia
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SN and DB study concept manuscript preparation, LR and OR critical discussion and support, JF and SG manuscript revision.

Corresponding author

Correspondence to Silvia Nardelli.

Ethics declarations

Ethics approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Consent to participate and consent for publication

This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of interests

The authors declare no conflict of interest.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Silvia Nardelli and Daniele Bellafante are co-first author.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nardelli, S., Bellafante, D., Ridola, L. et al. Prevention of post-tips hepatic encephalopathy: The search of the ideal candidate. Metab Brain Dis 38, 1729–1736 (2023). https://doi.org/10.1007/s11011-022-01131-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11011-022-01131-0

Keywords

Search

Navigation