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CC BY 4.0 · The Arab Journal of Interventional Radiology
DOI: 10.1055/s-0044-1785526
Original Article

Trans-splenic Approach for Transjugular Intrahepatic Portosystemic Shunt (TIPS) Creation in Patients with Portal Vein Thrombosis

Maryam Boumezrag
1   Medstar Georgetown University Hospital, Washington, District of Columbia, United States
,
George Lynskey
2   National Vascular Physicians, National Harbor, Maryland, United States
,
Saher Sabri
1   Medstar Georgetown University Hospital, Washington, District of Columbia, United States
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Abstract

Purpose The aim of this study was to evaluate the safety and efficacy of using a trans-splenic approach for transjugular intrahepatic portosystemic shunt (TIPS) creation in patients with portal vein thrombosis. (PVT).

Materials and Methods A retrospective review was performed on 36 consecutive patients with PVT who underwent TIPS using a trans-splenic approach from February 2018 to June 2021. Preprocedural data including demographic information and Model for End-Stage Liver Disease (MELD) scores were obtained. Outcomes measured included technical success, clinical success, complications, and survival.

Results Technical success was achieved in 32 of 36 patients (89%). During the follow-up period, 16 of 32 (50%) required secondary TIPS interventions, most of which were planned as part of a staged procedure. TIPS patency was 30/32 (94%) had stent patency on their most recent follow-up with a median follow-up of 164 days. No patients had variceal bleeding following TIPS. Eleven of thirty-two (34%) patients underwent successful transplant after TIPS. Anatomical portal vein end-to-end anastomosis was achieved in 11/12 (92%) patients.

Conclusion The trans-splenic approach to TIPS is a reliable alternative to traditional TIPS in patients with PVT and provides high technical and clinical success rates. This technique can also be utilized to improve future liver transplant outcomes by facilitating anatomic portal vein end-to-end anastomoses.

Keywords

cirrhosis - portal hypertension - TIPS - trans-splenic access - transjugular intrahepatic portosystemic shunt


Publication History

Article published online:
19 April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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