Controllable spring coil limiting TIPS shunt blood flow in treatment of refractory hepatic encephalopathy / 中国介入影像与治疗学

ABSTRACT

Objective: To explore the effects of Interlock controllable spring coils for limiting blood flow of TIPS shunt in refractory hepatic encephalopathy patient after TIPS. Methods: Interlock controllable spring coils were used to restrict shunt flow in 5 patients with refractory hepatic encephalopathy after TIPS operation. Results: Totally 7 controllable spring coils were implanted in all 5 cases, including 3 coils of 10 mm×25 cm, 1 coil of 15 mm×25 cm and 3 coils of 10 mm×40 cm. Combined with symptomatic treatment after TIPS, the symptoms of hepatic encephalopathy were significantly improved in 1 patient, while in 2 patients recurrent hepatic encephalopathy symptoms were observed within 2 months after restriction and disappeared after the second restriction. In 2 patients with symptoms of portal vein hypertension 2 weeks after the first restriction, 8 mm×60 mm balloon was selected to expand the shunt channel, and then 8 mm×60 mm Nitinol alloy stent was implanted in each one, and no symptom of hepatic encephalopathy nor portal vein hypertension occurred after the stent implantation. Conclusion: It is safe and reliable to treat refractory hepatic encephalopathy after TIPS (5 cases) with coils implantation for limiting blood flow.