Portosystemic encephalopathy is one of the most important complications of liver cirrhosis. The restoration of normal hepatic function and the reduction of portosystemic shunts by means of a liver graft are followed by the resolution of hepatic encephalopathy. We report the case of a patient with a normal functioning graft that developed recurrent encephalopathy after transplantation. The patient was successfully treated by embolization of a large portosystemic shunt between the superior mesenteric vein and both gonadal veins, this causing an inversion of the superior mesenteric vein flow.

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Compared with conventional angioplasty, cryoplasty showed good immediate success rates with lower stent placement rates. During the 3-year follow-up, patency rates tended to equalize between the two modalities.

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