{
    "abstract": "The transjugular intrahepatic portosystemic shunt procedure remains technically challenging in cases involving occlusion of the portal trunk. This study aimed to evaluate the feasibility, efficacy, and safety of utilizing the inferior vena cava-splenic vein shunt (IVCSS) as a new treatment option in cirrhotic patients with complete portal trunk occlusion and portal cavernoma.\nThe IVCSS procedure was performed on twelve patients, involving the creation of a shunt using a covered stent between the inferior vena cava and the proximal end of the splenic vein to reduce distal portal pressure.\nTechnical success was achieved in all patients, with a mean procedure duration of 71.7\u2009\u00b1\u200944.2\u2009min. The portosystemic gradient was reduced by a mean of 11.0\u2009\u00b1\u20095.6\u2009mmHg after the procedure. After a median follow-up of 6.7 [2.8-11.4] months, clinical symptoms improved in all patients. Stent dysfunction occurred in 1 patient, the recurrence rates for variceal bleeding and ascites were 8.3% and 16.7%, respectively. One patient (8.3%) experienced a procedure-related complication of retroperitoneal hemorrhage. Three patients (25%) had an episode of hepatic encephalopathy, which improved after conservative treatment.\nIVCSS effectively reduced distal portal pressure, which contributed to an improvement of the patients' clinical symptoms with an acceptable procedure-related complication rate. IVCSS may serve as an alternative strategy to manage symptomatic portal hypertension for patients with complete portal trunk occlusion and portal cavernoma.\nQuestion What is an alternative treatment for cirrhotic patients with symptomatic portal hypertension caused by chronic portal vein occlusion other than TIPS? Findings Inferior vena cava-splenic vein shunt (IVCSS) is feasible for reducing distal portal pressure and effectively improving clinical symptoms. Clinical relevance For cirrhotic patients with complete portal trunk occlusion and portal cavernoma, the IVCSS approach seemed to be a promising alternative treatment for symptomatic portal hypertension.",
    "authors": [
        {
            "affiliation": "Department of Minimally Invasive Intervention, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.",
            "firstname": "Maoyuan",
            "initials": "M",
            "lastname": "Mu"
        },
        {
            "affiliation": "Department of Minimally Invasive Intervention, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.",
            "firstname": "Yuzhe",
            "initials": "Y",
            "lastname": "Cao"
        },
        {
            "affiliation": "Department of Minimally Invasive Intervention, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.",
            "firstname": "Zixiong",
            "initials": "Z",
            "lastname": "Chen"
        },
        {
            "affiliation": "Department of Minimally Invasive Intervention, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.",
            "firstname": "Xiaobo",
            "initials": "X",
            "lastname": "Fu"
        },
        {
            "affiliation": "Department of Interventional Radiology, Liuzhou Municipal Liutie Central Hospital, Liuzhou, P. R. China.",
            "firstname": "Pengyi",
            "initials": "P",
            "lastname": "Chen"
        },
        {
            "affiliation": "Department of Minimally Invasive Intervention, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China. qihan@sysucc.org.cn.",
            "firstname": "Han",
            "initials": "H",
            "lastname": "Qi"
        },
        {
            "affiliation": "Department of Minimally Invasive Intervention, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China. gaof@sysucc.org.cn.",
            "firstname": "Fei",
            "initials": "F",
            "lastname": "Gao"
        }
    ],
    "conclusions": "IVCSS effectively reduced distal portal pressure, which contributed to an improvement of the patients' clinical symptoms with an acceptable procedure-related complication rate. IVCSS may serve as an alternative strategy to manage symptomatic portal hypertension for patients with complete portal trunk occlusion and portal cavernoma.",
    "copyrights": "\u00a9 2025. The Author(s), under exclusive licence to European Society of Radiology.",
    "doi": "10.1007/s00330-025-11571-8\n10.1016/s2468-1253(24)00155-9\n10.1016/j.jhep.2021.04.029\n10.1016/j.jhep.2021.12.022\n10.1002/hep.31646\n10.3350/cmh.2021.0239\n10.1016/j.jhep.2010.06.029\n10.1007/s00330-015-3777-1\n10.1111/1751-2980.12702\n10.1016/j.hbpd.2018.09.008\n10.1016/j.jvir.2014.12.012\n10.1111/apt.15044\n10.1038/srep33069\n10.1007/s12072-023-10522-z\n10.1007/s00270-020-02713-0\n10.1016/s1051-0443(96)70847-3\n10.1016/j.jvir.2011.09.029\n10.1016/j.jvir.2011.09.023\n10.3349/ymj.2018.59.1.162\n10.1016/j.avsg.2017.08.040",
    "journal": "European radiology",
    "keywords": [
        "Interventional radiology",
        "Portal hypertension",
        "Portal vein",
        "Therapeutics",
        "Venous thrombosis"
    ],
    "methods": null,
    "publication_date": "2025-04-17",
    "pubmed_id": "40244406\n38996577\n33930474\n35120736\n33219529\n34571587\n20932597\n25903717\n30629804\n30262421\n25666626\n27620282\n15239270\n37097537\n8897349\n22221479\n22464719\n29214793",
    "results": "Technical success was achieved in all patients, with a mean procedure duration of 71.7\u2009\u00b1\u200944.2\u2009min. The portosystemic gradient was reduced by a mean of 11.0\u2009\u00b1\u20095.6\u2009mmHg after the procedure. After a median follow-up of 6.7 [2.8-11.4] months, clinical symptoms improved in all patients. Stent dysfunction occurred in 1 patient, the recurrence rates for variceal bleeding and ascites were 8.3% and 16.7%, respectively. One patient (8.3%) experienced a procedure-related complication of retroperitoneal hemorrhage. Three patients (25%) had an episode of hepatic encephalopathy, which improved after conservative treatment.",
    "title": "Inferior vena cava-splenic vein shunt for the treatment of complete portal trunk occlusion and portal cavernoma in liver cirrhosis.",
    "xml": "<Element 'PubmedArticle' at 0x788502e6bce0>"
}