ArticleHepatology international2024
Efficacy and safety of precision-guided transjugular extrahepatic portosystemic shunt (TEPS) in the management of cavernous transformation of the portal vein with portal hypertension: a case series.
Article in Hepatology international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Transmesenteric Extrahepatic Portosystemic Shunt for Cavernous Transformation of Portal Vein with Superior Mesenteric Vein Occlusion.Cardiovascular and interventional radiology · 2026Article
- Endovascular management of extrahepatic portal vein obstruction (EHPVO): expanding beyond surgical shunts.Abdominal radiology (New York) · 2026Review
- Surgery-assisted transmesenteric transjugular intrahepatic portosystemic shunt for esophagogastric bleeding in patients with cavernous transformation of the portal vein.World journal of gastrointestinal surgery · 2026Article
- Transabdominal Ultrasound-guided Transjugular Endovascular Mesocaval Shunt Creation in Extrahepatic Portal Vein Obstruction: A Single-center Experience.Interventional radiology (Higashimatsuyama-shi (Japan) · 2026Article
- Case Report: Percutaneous portal-central venous bypass: a novel salvage therapy for refractory variceal bleeding in TIPS-ineligible patients with portal vein tumor thrombus.Frontiers in medicine · 2026Article
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Authors and funding
9 authors.
Funding
Abstract
BACKGROUND AND
aimsPerforming a Transjugular intrahepatic portal system shunt (TIPS) in patients with portal vein cavernous transformation (CTPV) poses significant challenges. As an alternative, transjugular extrahepatic portal vein shunt (TEPS) may offer a potential solution for these patients. Nonetheless, the effectiveness and safety of TEPS remain uncertain. This case series study aimed to evaluate the efficacy and safety of TEPS in treating patients with CTPV portal hypertension complications.
methodsThe study encompassed a cohort of 22 patients diagnosed with CTPV who underwent TEPS procedures. Of these, 13 patients manifested recurrent hemorrhagic episodes subsequent to conventional therapies, 8 patients grappled with recurrent or refractory ascites, and 1 patient experienced acute bleeding but refused endoscopic treatment. Comprehensive postoperative monitoring was conducted for all patients to rigorously evaluate both the technical and clinical efficacy of the intervention, as well as long-term outcomes.
resultsThe overall procedural success rate among the 22 patients was 95.5% (21/22).During the TEPS procedure, nine patients were guided by percutaneous splenic access, three patients were guided by percutaneous hepatic access, five patients were guided by transmesenteric vein access from the abdomen, and two patients were guided by catheter marking from the hepatic artery. Additionally, guidance for three patients was facilitated by pre-existing TIPS stents. The postoperative portal pressure gradient following TEPS demonstrated a statistically significant decrease compared to preoperative values (24.95 ± 3.19 mmHg vs. 11.48 ± 1.74 mmHg, p < 0.01).Although three patients encountered perioperative complications, their conditions ameliorated following symptomatic treatment, and no procedure-related fatalities occurred. During a median follow-up period of 14 months, spanning a range of 5 to 39 months, we observed four fatalities. Specifically, one death was attributed to hepatocellular carcinoma, while the remaining three were ascribed to chronic liver failure. During the follow-up period, no instances of shunt dysfunction were observed.
conclusionsPrecision-guided TEPS appears to be a safe and efficacious intervention for the management of CTPV.
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