Embolization of spontaneous portosystemic shunts as treatment for refractory hepatic encephalopathy

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dc.contributor.authorBenitez, Carlos
dc.contributor.authorMunoz, Ana
dc.contributor.authorPoniachik, Jaime
dc.contributor.authorRamirez, Felipe
dc.contributor.authorMunoz, Claudia
dc.contributor.authorCermenati, Tomas
dc.contributor.authorMartinez, Nicolas
dc.contributor.authorDiaz, Pia
dc.contributor.authorMeneses, Luis
dc.date.accessioned2025-01-20T21:00:40Z
dc.date.available2025-01-20T21:00:40Z
dc.date.issued2022
dc.description.abstractBackground: Hepatic encephalopathy (HE) is a common complication of cirrhosis associated with a reduced survival. The presence of high-flux spontaneous porto-systemic shunts can induce HE even in patients with preserved liver function. Aim: To evaluate the effect of spontaneous porto-systemic shunt embolization (SPSE) over HE and its long-term evolution. Material and Methods: Retrospective analysis of 11 patients (91% males) with severe HE non-responsive to medical treatment in whom a SPSE was performed. The grade of HE (employing West Haven score), survival, MELD and Child-Pugh score, ammonia levels, degree of disability (employing the modified Rankin scale (mRs)) were evaluated before and at thirty days after procedure. Results: The most common etiology found was non-alcoholic steatohepatitis (63.6%). A reduction of at least two score points of HE was observed in all patients after thirty days. There was a significant reduction on median (IQR) West Haven score from 3 (2-3) at baseline to 1 (0-1) after the procedure (p < 0.01). Twelve months survival was 63.6%. There was a decrease in median ammonia level from 106.5 (79-165) (ug/dL) to 56 (43-61) after SPSE (p = 0.006). The median mRS score before and after the procedure was 3 (3-5) and 1 (1-2.5), respectively (p < 0.01). Conclusions: According to our experience, SPSE is a feasible and effective alternative to improve HE and functionality of patients with refractory EH.
dc.fuente.origenWOS
dc.identifier.eissn0717-6163
dc.identifier.issn0034-9887
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/92728
dc.identifier.wosidWOS:000968680000005
dc.issue.numero7
dc.language.isoen
dc.pagina.final888
dc.pagina.inicio879
dc.revistaRevista medica de chile
dc.rightsacceso restringido
dc.subjectEmbolization
dc.subjectTherapeutic
dc.subjectFibrosis
dc.subjectHepatic Encephalopathy
dc.subjectLiver Cirrhosis
dc.subjectPortosystemic Shunt
dc.subjectSurgical
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleEmbolization of spontaneous portosystemic shunts as treatment for refractory hepatic encephalopathy
dc.typeartículo
dc.volumen150
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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