Transjugular intrahepatic portosystemic shunt for the treatment of portal hypertension complications: A single-center retrospective cohort

<h2>Abstract</h2><h3>Objective</h3> We evaluated the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) for the treatment of portal hypertension complications. <h3>Methods</h3> We retrospectively analyzed the demographics, treatment details, and outcomes data of 89 patients with portal hypertension complications treated with TIPS from March 2020 to June 2023. The etiology of portal hypertension included viral hepatitis, alcoholic liver disease, autoimmune liver disease, sinusoidal obstruction syndrome, and Budd-Chiari syndrome. <h3>Results</h3> The final study population consisted of 89 patients, including 43 patients with viral hepatitis, 21 with alcoholic liver disease, 18 with autoimmune liver disease, 4 with sinusoidal obstruction syndrome, and 3 with Budd-Chiari syndrome. Five emergent and 84 elective TIPS procedures were carried out, and the TIPS technical procedure successful rate was 100%. The stent configuration included 5 cases with a bare metal stent, 42 cases with a multilayer bare metal stent, 32 cases with a bare and covered stent combination, and 10 cases with a stent designed for TIPS. The preprocedural and postprocedural mean portocaval pressure gradient was 27.66 ± 5.69 and 13.73 ± 3.63 cm H₂O (<i>P</i> < .05), respectively. The 1-year recurrent variceal bleeding or refractory ascites rate was 12.36% and the 1-year TIPS shunt dysfunction rate was 13.48%. The incidence of overt encephalopathy and minimal encephalopathy was 8.99% and 21.35%, respectively. One patient suffered from hepatic coma and treated with TIPS shunt embolization. During the 1-year follow-up, seven patients were diagnosed with hepatocellular carcinoma, three patients underwent liver transplantation, and six patients died. <h3>Conclusions</h3> TIPS is a safe and effective treatment modality for portal hypertension complications. The incidence of hepatic encephalopathy is acceptable by proper patient selection and pharmacological treatment. More attention should be paid to this technique in China to benefit the large amounts of patients with complications of portal hypertension.