Transjugular intrahepatic portosystemic shunt placement in patients with cirrhosis and concomitant portal vein thrombosis

Cardiovasc Intervent Radiol. 2006 Sep-Oct;29(5):785-90. doi: 10.1007/s00270-005-0090-4.


Purpose: To determine the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) creation in patients with liver cirrhosis complicated by thrombosed portal vein.

Methods: This study reviewed 15 cases of TIPS creation in 15 cirrhotic patients with portal vein thrombosis at our institution over an 8-year period. There were 2 women and 13 men with a mean age of 53 years. Indications were refractory ascites, variceal hemorrhage, and refractory pleural effusion. Clinical follow-up was performed in all patients.

Results: The technical success rate was 75% (3/4) in patients with chronic portal vein thrombosis associated with cavernomatous transformation and 91% (10/11) in patients with acute thrombosis or partial thrombosis, giving an overall success rate of 87%. Complications included postprocedural encephalopathy and localized hematoma at the access site. In patients with successful shunt placement, the total follow-up time was 223 months. The 30-day mortality rate was 13%. Two patients underwent liver transplantation at 35 days and 7 months, respectively, after TIPS insertion. One patient had an occluded shunt at 4 months with an unsuccessful revision. The remaining patients had functioning shunts at follow-up.

Conclusion: TIPS creation in thrombosed portal vein is possible and might be a treatment option in certain patients.

MeSH terms

  • Adult
  • Aged
  • Esophageal and Gastric Varices / complications
  • Esophageal and Gastric Varices / surgery
  • Female
  • Gastrointestinal Hemorrhage / etiology
  • Humans
  • Liver Cirrhosis / complications*
  • Male
  • Middle Aged
  • Portal Vein*
  • Portasystemic Shunt, Transjugular Intrahepatic*
  • Venous Thrombosis / surgery*