scholarly journals Vascular Plug-Assisted Retrograde Transvenous Obliteration of Portosystemic Shunts for Refractory Hepatic Encephalopathy: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Jonathan K. Park ◽  
Sung-Ki Cho ◽  
Stephen Kee ◽  
Edward W. Lee
Keyword(s):  
Case Report ◽  
Hepatic Encephalopathy ◽  
Portosystemic Shunt ◽  
Vascular Plug ◽  
Portosystemic Encephalopathy ◽  
Portosystemic Shunts ◽  
American Case ◽  
Refractory Hepatic Encephalopathy ◽  
Shunt Closure ◽  
Emerging Therapy

While balloon-assisted retrograde transvenous obliteration (BRTO) has been used for two decades in Asia for the management of gastric variceal bleeding, it is still an emerging therapy elsewhere. Given the shunt closure brought about by the procedure, BRTO has also been used for the management of portosystemic encephalopathy with promising results. Modified versions of BRTO have been developed, including plug-assisted retrograde transvenous obliteration (PARTO), where a vascular plug is deployed within a portosystemic shunt. To our knowledge, we present the first North American case of PARTO in the setting of a large splenorenal shunt for the management of portosystemic encephalopathy.

scholarly journals Spontaneous portosystemic shunts in liver cirrhosis: new approaches to an old problem

2020 ◽  
Vol 13 ◽  
pp. 175628482096128 ◽  
Author(s):  
Judit Vidal-González ◽  
Sergi Quiroga ◽  
Macarena Simón-Talero ◽  
Joan Genescà
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Portosystemic Shunt ◽  
Venous System ◽  
Variceal Hemorrhage ◽  
Portal Venous System ◽  
Portal Flow ◽  
Portosystemic Shunts ◽  
Intrahepatic Portosystemic Shunt

Portal hypertension is the main consequence of liver cirrhosis, leading to severe complications such as variceal hemorrhage, ascites or hepatic encephalopathy. As an attempt to decompress the portal venous system, portal flow is derived into the systemic venous system through spontaneous portosystemic shunts (SPSSs), bypassing the liver. In this review, we aim to provide an overview of the published reports in relation to the prevalence and physiopathology behind the appearance of SPSS in liver cirrhosis, as well as the complications derived from its formation and its management. The role of SPSS embolization is specifically discussed, as SPSSs have been assessed as a therapeutic target, mainly for patients with recurrent/persistent hepatic encephalopathy and preserved liver function. Furthermore, different aspects of the role of SPSS in liver transplantation, as well as in candidates for transjugular intrahepatic portosystemic shunt are reviewed. In these settings, SPSS occlusion has been proposed to minimize possible deleterious effects, but results are so far inconclusive.

scholarly journals Embolization of large spontaneous portosystemic shunts for refractory hepatic encephalopathy: A multicenter survey on safety and efficacy

Hepatology ◽  
2013 ◽  
Vol 57 (6) ◽  
pp. 2448-2457 ◽  
Author(s):  
Wim Laleman ◽  
Macarena Simon-Talero ◽  
Geert Maleux ◽  
Mercedes Perez ◽  
Koen Ameloot ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Safety And Efficacy ◽  
Portosystemic Shunts ◽  
Multicenter Survey ◽  
Refractory Hepatic Encephalopathy
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