Selective Splenic Artery Embolization for Refractory Transjugular Intrahepatic Portosystemic Shunt-Induced Hepatic Encephalopathy

Transjugular intrahepatic portosystemic shunt (TIPS) is a mainstay treatment for complications of portal hypertension. Despite advances in covered stents, hepatic encephalopathy (HE) remains a common complication, affecting 21%-53% of patients within one year. Refractory HE, often resistant to medical therapy, poses significant management challenges. We present a case of refractory post-TIPS HE successfully managed with selective splenic artery embolization (SSAE), underscoring its therapeutic potential.