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Updated: May 30, 2026

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
Published on: August 1, 2018
Transjugular intrahepatic portosystemic shunt does not alter cerebral blood flow
Peter Iversen1, Susanne Keiding, Kim Mouridsen
1Department of Nuclear Medicine and PET Center, Aarhus University Hospital, Aarhus, Denmark. piv@pet.auh.dk
Background & Aims:
Cirrhosis patients with symptomatic portal hypertension might be effectively treated with a transjugular intrahepatic portosystemic shunt stent (TIPS). The intervention, however, carries a risk of debilitating portosystemic hepatic encephalopathy (HE). HE in cirrhosis might be associated with decreased cerebral blood flow (CBF), and CBF might decrease after TIPS.
Methods:
We measured CBF by [(15)O]-water positron emission tomography (PET) in 9 nonencephalopathic cirrhosis patients before and median 11 days after the insertion of TIPS. The PET images were co-registered to magnetic resonance images for region-based analysis.
Results:
Pre-TIPS whole-brain CBF varied markedly from very low to high-normal values of 0.28-0.58 mL blood/mL of brain tissue/min. There were no systematic changes in whole-brain or regional CBF after the TIPS treatment (P > .1). No patient had HE after TIPS.
Conclusions:
Treating portal hypertension by TIPS in patients with advanced cirrhosis and without HE had no effect on their CBF and seemed not to entail a risk of cerebral hypoperfusion.
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