Treatment of chronic portosystemic encephalopathy in cirrhotic patients by embolization of portosystemic shunts

Liver Int. 2007 Dec;27(10):1389-93. doi: 10.1111/j.1478-3231.2007.01602.x.

Abstract

AIMS/BACKGROUNDS: Large spontaneous portal-systemic shunts can occasionally be the cause of chronic and disabling encephalopathy in cirrhotic patients. Shunt embolization has been proposed, however the clinical relevance of this technique remains uncertain.

Methods/results: We report our results in seven patients treated by shunt embolization. Although the procedure was achieved and technically successful in all patients, the clinical results were poor as long-term improvement was obtained in only one patient. Three patients died within 3 months after the procedure from cirrhoses' end stage complications.

Conclusion: We believe that optimal management of these patients with chronic spontaneous encephalopathy is liver transplantation.

MeSH terms

  • Aged
  • Angiography
  • Chronic Disease
  • Embolization, Therapeutic*
  • Hepatic Encephalopathy / diagnostic imaging
  • Hepatic Encephalopathy / therapy*
  • Hepatitis C, Chronic / diagnostic imaging
  • Hepatitis C, Chronic / therapy
  • Humans
  • Liver Cirrhosis, Alcoholic / diagnostic imaging
  • Liver Cirrhosis, Alcoholic / therapy*
  • Liver Transplantation
  • Middle Aged
  • Portal System / diagnostic imaging
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome