Acute cerebrovascular incident as a complication of TIPS procedure.

The formation of a transjugular intrahepatic portosystemic shunt (TIPS) is a well-established procedure in the management of complications of severe portal hypertension. It is also performed if portal hypertension is a result of acute portal vein thrombosis. We report the case of an acute cerebrovascular incident after TIPS formation in a patient with partial portal vein thrombosis. Even when no patent foramen ovale (PFO) is detectable the presence of PFO and thus the risk of cerebrovascular incident cannot be excluded. We therefore propose to inform patients with preexisting portal vein thrombosis prior to undergoing this intervention that TIPS procedure may be associated with the risk of cerebral embolization.