During interventional procedures, the deficiencies of nonstereoscopic vision increase the difficulty of identifying the anteroposterior direction and pathways of vessels. Therefore, achieving real-time stereoscopic vision during interventional procedures is meaningful. Pairs of X-ray images were captured with identical parameter settings, except for different rotation angles (represented as the α angle). The resulting images at these α angles were used as left-eye and right-eye views and were horizontally merged into single left-right 3D images. Virtual reality (VR) glasses were used for achieving stereo vision. Pairs of X-ray images from four angiographies with different α angles (1.8–3.4°) were merged into left-right 3D images. Observation with VR glasses can produce realistic stereo views of vascular anatomical structure. The results showed that the optimal α angles accepted by the brain for generating stereo vision were within a narrow range (approximately 1.4–4.1°). Subsequent tests showed that during transcatheter arterial chemoembolization, 3D X-ray stereoscopic images provided significantly improved spatial discrimination and convenience for identifying the supply vessels of a liver tumor and its anteroposterior direction compared with plain X-ray images (all P < 0.01). Real-time X-ray stereoscopic vision can be easily achieved via the straightforward method described herein and has the potential to benefit patients during interventional procedures.

Transjugular intrahepatic portosystemic shunts (TIPSs) are generally used for the management of complications of portal hypertension in patients with decompensated cirrhosis. However, hepatic encephalopathy (HE), which impairs neuropsychiatric function and motor control, remains the primary adverse effect of TIPS, limiting its utility. Prompt prevention and treatment of post-TIPS HE are critical, as they are strongly associated with readmission rates and poor quality of life. This review focuses on the main pathophysiological mechanisms underlying post-TIPS HE, explores advanced biomarkers and predictive tools, and discusses current management strategies and future directions to prevent or reverse HE following TIPS. These strategies include preoperative patient assessment, individualized shunt diameter optimization, spontaneous portosystemic shunt embolization during the TIPS procedure, postoperative preventive and therapeutic measures such as nutrition management, medical therapy, fecal microbiota transplantation, and stent reduction.