2015, Number 1
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Ann Hepatol 2015; 14 (1)
Paradoxical embolization in TIPS: take a closer look to the heart
Vizzutti F, Rega L, Arena U, Giulio RR, Meucci F, Barletta G, Schepis F, Tsalouchos A, Laffi G, Marra F
Language: English
References: 13
Page: 127-131
PDF size: 154.73 Kb.
ABSTRACT
No definitive indications are provided in the literature for pre-TIPS patient workup, which is often limited
to prevent the incidence of refractory hepatic encephalopathy or unacceptable deterioration of liver
function. Concerning cardiologic workup, efforts are generally limited at excluding ventricular failure or
porto-pulmonary hypertension. The cases presented herein focus the attention of the readers on the
possible occurrence of post-TIPS paradoxical embolization in the presence of a patent foramen ovale, frequently
recognized in adult population. In conclusion, although this complication has been already reported
in literature, in the present manuscript we concentrate on possible additional risk factors which may
allow to identify a subset of patients with a higher likelihood to experience paradoxical embolization following
TIPS. Another important line of information presented herein is the feasibility of percutaneous closure
of a patent foramen ovale before TIPS deployment in the presence of portal vein thrombosis and
possibly with additional risk factors.
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