Embolization of spontaneous portosystemic shunt for cirrhotic patients with portal hypertension: a review of current status

Spontaneous portosystemic shunt( SPSS) has not yet drawn enough attention. The incidence of SPSS in cirrhotic patients is 38%-40%,and 46%-70% of cirrhotic patients with refractory encephalopathy show SPSS. Embolization of SPSS may be a safe and effective method for the treatment of refractory encephalopathy in patients with cirrhosis. The critical role of transjugular intrahepatic portosystemic shunt( TIPS) in the prevention and treatment of the complications of portal hypertension has been demonstrated. To further reduce portal pressure and prevent gastroesophageal variceal rebleeding,TIPS is essential for the treatment of cirrhotic patients with SPSS. Meanwhile,TIPS with SPSS embolization may reduce the post-TIPS complications,and the patients may benefit more from TIPS. Prospective randomized controlled trials are warranted to further confirm these findings.