Shunt magnitude is a key determinant of overt hepatic encephalopathy in patients undergoing TIPS

Roccarina, Davide; Saltini, Dario; Senzolo, Marco; Nardelli, Silvia; Rosi, Martina; Adotti, Valentina; Bianchini, Marcello; Biribin, Lara; Gioia, Stefania; Caporali, Cristian; Ragozzino, Lucia; Guasconi, Tomas; Falcini, Margherita; Casari, Federico; Piscopo, Antonio; Pindozzi, Francesco; Gitto, Stefano; Aspite, Silvia; Falcone, Gianmarco; Ingravallo, Angelica; Gaggini, Melania; Ferdinande, Kymentie; Arena, Umberto; Merli, Manuela; Ridola, Lorenzo; Riggio, Oliviero; Fanelli, Fabrizio; Mangini, Chiara; Marra, Fabio; Montagnese, Sara; Schepis, Filippo; Vizzutti, Francesco

doi:10.1016/j.jhepr.2025.101676

TIPS carries a significant risk of overt hepatic encephalopathy. • Low portosystemic pressure gradient and larger shunt diameter have been reported to increase the risk of overt hepatic encephalopathy. • TIPS under dilation reduces overt hepatic encephalopathy occurrence while effectively controlling portal hypertension complications even without meeting established hemodynamic targets. • Thus, the TIPS dilation diameter represents an independent key determinant of post-TIPS overt hepatic encephalopathy.

Shunt magnitude is a key determinant of overt hepatic encephalopathy in patients undergoing TIPS / Roccarina, D., Saltini, D., Senzolo, M., Nardelli, S., Rosi, M., Adotti, V., Bianchini, M., Biribin, L., Gioia, S., Caporali, C., Ragozzino, L., Guasconi, T., Falcini, M., Casari, F., Piscopo, A., Pindozzi, F., Gitto, S., Aspite, S., Falcone, G., Ingravallo, A., et al.. - In: JHEP REPORTS. - ISSN 2589-5559. - ELETTRONICO. - (2026), pp. 0-0. [10.1016/j.jhepr.2025.101676]