TIPS in patients with portal and splanchnic vein thrombosis: a single center retrospective analysis

To study the safety, technical and short-term clinical success, patency of the TIPS, and factors leading to reintervention (RI) and re-thrombosis.

Materials and Methods:

This is an IRB-approved retrospective study of 25 pts who underwent TIPS between (8/19-10/22) for acute or chronic portal/splanchnic vein (SV) thrombosis leading to their partial or complete occlusion with refractory portal hypertension complications or listed for liver transplantation. Reviewed outcomes include technical success, complications, TIPS/PV/SV patency, and clinical success. Variables studied include involvement of venous confluence, SV occlusion, Yerdel grade, embolization of varix during the procedure, TIPS size & port-systemic gradient (PSG). Considering the small sample size, univariate logistic regression was used to test each predictor separately. A significance level of 0.05 was applied.

Results:

Table 1 for patient characteristics. Procedures were performed by 3 IR physicians. No significant predictors were found for occlusion (very small number). PSG has a significant and nonlinear effect on RI rate. Table 2 for results and Table 3 for analysis.

Conclusion:

With careful patient selection, high technical & clinical success with prolonged patency of the TIPS for advanced acute & chronic PV & SV thrombosis can be achieved with minimal morbidity. In our review, a nonlinear correlation was found between PSG and RI.