{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:19:52Z","timestamp":1790219992072,"version":"4.1.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T00:00:00Z","timestamp":1625702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T00:00:00Z","timestamp":1625702400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>Extrahepatic portal vein occlusion (EHPVO) from portal vein thrombosis is a rare condition associated with substantial morbidity and mortality. The purpose of this study is to investigate the efficacy of transjugular intrahepatic portosystemic shunts (TIPS) for the treatment of chronic EHPVO, cavernomatosis, and mesenteric venous thrombosis in adults without cirrhosis who are refractory to standard\u2010of\u2010care therapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>Thirty\u2010nine patients with chronic EHPVO received TIPS. Laboratory parameters and follow\u2010up were assessed at 1, 3, 6, 12, and 24\u00a0months, and every 6\u00a0months thereafter. Two hepatologists adjudicated symptom improvement attributable to mesenteric thrombosis and EHPVO before\/after TIPS. Kaplan\u2010Meier was used to assess primary and overall TIPS patency, assessing procedural success. Adverse events, radiation exposure, hospital length\u2010of\u2010stay and patency were recorded. Cavernoma was present in 100%, with TIPS being successful in all cases using splenic, mesenteric, and transhepatic approaches. Symptom improvement was noted in 26 of 30 (87%) at 6\u2010month follow\u2010up. Twelve patients (31%) experienced TIPS thrombosis. There were no significant long\u2010term laboratory adverse events or deaths. At 36\u00a0months, freedom from primary TIPS thrombosis was 63%; following secondary interventions, overall patency was increased to 81%.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>TIPS in chronic, noncirrhotic EHPVO with cavernomas and mesenteric venous thrombosis is technically feasible and does not adversely affect liver function. Most patients demonstrate subjective and objective benefit from TIPS. Improvement in patency rates are needed with proper timing of adjuvant anticoagulation.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.31915","type":"journal-article","created":{"date-parts":[[2021,5,22]],"date-time":"2021-05-22T00:19:56Z","timestamp":1621642796000},"page":"2735-2744","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":65,"title":["TIPS for Adults Without Cirrhosis With Chronic Mesenteric Venous Thrombosis and EHPVO Refractory to Standard\u2010of\u2010Care Therapy"],"prefix":"10.1097","volume":"74","author":[{"given":"Gabriel M.","family":"Knight","sequence":"first","affiliation":[{"name":"Department of Radiology,Section of Vascular and Interventional Radiology,Northwestern University,Chicago,IL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1214-3645","authenticated-orcid":false,"given":"Jeffrey","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Radiology,Section of Vascular and Interventional Radiology,Northwestern University,Chicago,IL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9364-8807","authenticated-orcid":false,"given":"Justin R.","family":"Boike","sequence":"additional","affiliation":[{"name":"Department of Medicine,Division of Gastroenterology and Hepatology,Northwestern University,Chicago,IL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haripriya","family":"Maddur","sequence":"additional","affiliation":[{"name":"Department of Medicine,Division of Gastroenterology and Hepatology,Northwestern University,Chicago,IL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel R.","family":"Ganger","sequence":"additional","affiliation":[{"name":"Department of Medicine,Division of Gastroenterology and Hepatology,Northwestern University,Chicago,IL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhinav","family":"Talwar","sequence":"additional","affiliation":[{"name":"Department of Radiology,Section of Vascular and Interventional Radiology,Northwestern University,Chicago,IL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahsun","family":"Riaz","sequence":"additional","affiliation":[{"name":"Department of Radiology,Section of Vascular and Interventional Radiology,Northwestern University,Chicago,IL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kush","family":"Desai","sequence":"additional","affiliation":[{"name":"Department of Radiology,Section of Vascular and Interventional Radiology,Northwestern University,Chicago,IL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samdeep","family":"Mouli","sequence":"additional","affiliation":[{"name":"Department of Radiology,Section of Vascular and Interventional Radiology,Northwestern University,Chicago,IL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Hohlastos","sequence":"additional","affiliation":[{"name":"Department of Radiology,Section of Vascular and Interventional Radiology,Northwestern University,Chicago,IL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9032-4954","authenticated-orcid":false,"given":"Juan\u2010Carlos","family":"Garcia Pagan","sequence":"additional","affiliation":[{"name":"Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Cl\u00ednic,Institut de Investigacions Biom\u00e8diques August Pi i Sunyer,University of Barcelona,Barcelona,Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica Red de enfermedades hep\u00e1ticas y digestivas,Barcelona,Spain"},{"name":"Health Care Provider of the European Reference Network on Rare Liver Disorders,Hamburg,Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6636-0189","authenticated-orcid":false,"given":"Ahmed","family":"Gabr","sequence":"additional","affiliation":[{"name":"Department of Radiology,Section of Vascular and Interventional Radiology,Northwestern University,Chicago,IL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brady","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Medicine,Division of Hematology,Northwestern University,Chicago,IL,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Lewandowski","sequence":"additional","affiliation":[{"name":"Department of Radiology,Section of Vascular and Interventional Radiology,Northwestern 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