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A grande discussão é se há possibilidade
de prever qual o paciente que desenvolverá encefalopatia
após a realização do TIPS. Parece que
os pacientes que já apresentaram algum episódio
de encefalopatia antes do TIPS têm um risco aumentado
desta complicação. No entanto, nem todos os
trabalhos sustentam esta linha de raciocínio.41
Outra observação é que a encefalopatia
é mais frequente em pacientes idosos,40
motivo pelo qual o diâmetro do "stent" deverá
ser menor nestes pacientes (±8mm).
Com base nos resultados publicados por vários
centros médicos, a incidência de encefalopatia portosistêmica
após a realização do TIPS parece variar de 18% a
32%13,14 dependendo do diâmetro
do "shunt", bem como do estado de compensação
da função hepática no momento de sua realização.
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