AUTHOR=Wang Hong-Liang , Lu Wei-Jie , Zhang Yue-Lin , Nie Chun-Hui , Zhou Tan-Yang , Zhou Guan-Hui , Zhu Tong-Yin , Wang Bao-Quan , Chen Sheng-Qun , Yu Zi-Niu , Jing Li , Sun Jun-Hui 

TITLE=Comparison of Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Cirrhosis With or Without Portal Vein Thrombosis: A Retrospective Study

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.737984

DOI=10.3389/fmed.2021.737984

ISSN=2296-858X

ABSTRACT=<p><bold>Aim:</bold> The purpose of our study was to conduct a retrospective analysis to compare the effectiveness of transjugular intrahepatic portosystemic shunts (TIPS) in the treatment of patients with cirrhosis with or without portal vein thrombosis (PVT).</p><p><bold>Methods:</bold> We included a total of 203 cirrhosis patients successfully treated with TIPS between January 2015 and January 2018, including 72 cirrhosis patients with PVT (35.5%) and 131 without PVT (64.5%). Our subjects were followed for at least 1 year after treatment with TIPS. Data were collected to estimate the mortality, shunt dysfunction, and complication rates after TIPS creation.</p><p><bold>Results:</bold> During the mean follow-up time of 19.5 ± 12.8 months, 21 (10.3%) patients died, 15 (7.4%) developed shunt dysfunction, and 44 (21.6%) experienced overt hepatic encephalopathy (OHE). No significant differences in mortality (<italic>P</italic> = 0.134), shunt dysfunction (<italic>P</italic> = 0.214), or OHE (<italic>P</italic> = 0.632) were noted between the groups. Age, model for end-stage liver disease (MELD) score, and refractory ascites requiring TIPS were risk factors for mortality. A history of diabetes, percutaneous transhepatic variceal embolization (PTVE), 8-mm diameter stent, and platelet (PLT) increased the risk of shunt dysfunction. The prevalence of variceal bleeding and recurrent ascites was comparable between the two groups (16.7 vs. 16.7% <italic>P</italic> = 0.998 and 2.7 vs. 3.8% <italic>P</italic> = 0.678, respectively).</p><p><bold>Conclusions:</bold> Transjugular intrahepatic portosystemic shunts are feasible in the management of cirrhosis with PVT. No significant differences in survival or shunt dysfunction were noted between the PVT and no-PVT groups. The risk of recurrent variceal bleeding, recurrent ascites, and OHE in the PVT group was generally similar to that in the no-PVT group. TIPS represents a potentially feasible treatment option in cirrhosis patients with PVT.</p>