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We evaluated the effectiveness of CX-TIPS in a\u00a0large Viennese patient cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We assessed the number of patients evaluated for CX-TIPS placement by interdisciplinary discussion at the Medical University of Vienna and included all patients from the prospective AUTIPS registry undergoing CX-TIPS placement between June 2018 \u2013 December 2024. After clinical and laboratory characterization at baseline, patients were followed up for clinical events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 200 patients underwent interdisciplinary evaluation for CX-TIPS. In 62.5% CX-TIPS was recommended and 82.4% of these patients underwent CX-TIPS placement. Among 103 patients with CX-TIPS placement between June 2018 \u2013 December 2024 (median age\u00a057\u00a0years, 67.0% male, median MELD\u00a011), the primary indication for CX-TIPS implantation was ascites (65.0%). The median portal pressure gradient decreased from 18\u202fmm\u202fHg to 8\u202fmm\u202fHg after CX-TIPS. Underdilated CX-TIPS placement was performed in 13.6% (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u200914) of patients and portal vein recanalization (PVR-TIPS) was performed in 4\u00a0patients. During a\u00a0median follow-up time of 13.5 months, 30.1% of patients experienced hepatic encephalopathy and 5.8% cardiac decompensation. Kaplan-Meier survival analyses revealed 1\u2011year and 3\u2011year transplant-free survival rates of 78.0% and 74.7%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Implementation of interdisciplinary case discussions and the use of CX-TIPS enable personalized medicine in patients with cirrhosis. Underdilation of CX-TIPS should be considered in patients at high risk for complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00508-025-02606-7","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T14:21:34Z","timestamp":1756995694000},"page":"144-153","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effectiveness of controlled-expansion transjugular intrahepatic portosystemic shunt (CX-TIPS) in an interdisciplinary setting at a\u00a0large tertiary center"],"prefix":"10.1007","volume":"138","author":[{"given":"Marlene","family":"Hintersteininger","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Kappel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"M\u00fcllner-Buscics","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna","family":"Riegler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Dominik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg","family":"Kramer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Sebesta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Th\u00f6ne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert Friedrich","family":"St\u00e4ttermayer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Reider","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Schoder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catharina","family":"Klausenitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raoul","family":"Varga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fredrik","family":"Waneck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Trauner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mattias","family":"Mandorfer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4590-3583","authenticated-orcid":false,"given":"Thomas","family":"Reiberger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Hartl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"issue":"5","key":"2606_CR1","first-page":"245","volume":"2020","author":"SG Sepanlou","year":"2017","unstructured":"Sepanlou\u00a0SG, Safiri\u00a0S, Bisignano\u00a0C, Ikuta\u00a0KS, Merat\u00a0S, Saberifiroozi\u00a0M, Poustchi\u00a0H, et\u00a0al. 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Episodic overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt does not increase mortality in patients with cirrhosis. J\u00a0Hepatol. 2024;80:596\u2013602.","journal-title":"J Hepatol"},{"key":"2606_CR31","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1111\/apt.18509","volume":"61","author":"Y Xiang","year":"2025","unstructured":"Xiang\u00a0Y, Tie\u00a0J, Wang\u00a0G, Zhuge\u00a0Y, Wu\u00a0H, Zhu\u00a0X, Xue\u00a0H, et\u00a0al. Post-TIPS overt hepatic encephalopathy increases long-term but not short-term mortality in cirrhotic patients with variceal bleeding: a\u00a0large-scale, multicenter real-world study. Aliment Pharmacol Ther. 2025;61:1183\u201396.","journal-title":"Aliment Pharmacol Ther"},{"key":"2606_CR32","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.1016\/j.cgh.2018.01.029","volume":"16","author":"F Schepis","year":"2018","unstructured":"Schepis\u00a0F, Vizzutti\u00a0F, Garcia-Tsao\u00a0G, Marzocchi\u00a0G, Rega\u00a0L, De Maria\u00a0N, Di Maira\u00a0T, et\u00a0al. Under-dilated TIPS associate with efficacy and reduced encephalopathy in a\u00a0prospective, non-randomized study of patients with cirrhosis. Clin Gastroenterol Hepatol. 2018;16:1153\u20131162.e1157.","journal-title":"Clin Gastroenterol Hepatol"}],"container-title":["Wiener klinische Wochenschrift"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00508-025-02606-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00508-025-02606-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00508-025-02606-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T16:30:08Z","timestamp":1773678608000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00508-025-02606-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,4]]},"references-count":32,"journal-issue":{"issue":"5-6","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["2606"],"URL":"https:\/\/doi.org\/10.1007\/s00508-025-02606-7","relation":{},"ISSN":["0043-5325","1613-7671"],"issn-type":[{"value":"0043-5325","type":"print"},{"value":"1613-7671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,4]]},"assertion":[{"value":"12 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"J.\u00a0Kappel, T.\u00a0M\u00fcllner-Buscics, S.\u00a0Riegler, N.\u00a0Dominik, G.\u00a0Kramer, C.\u00a0Sebesta, P.\u00a0Th\u00f6ne, A.F.\u00a0St\u00e4ttermayer, L.\u00a0Reider, M.\u00a0Schoder, C.\u00a0Klausenitz, R.\u00a0Varga and F.\u00a0Waneck declare that they have no competing interests. M.\u00a0Hintersteininger received travel support from Roche. M.\u00a0Trauner served as a\u00a0speaker and\/or consultant and\/or advisory board member for Agomab, Albireo, BiomX, Chemomab, Falk, Boehringer Ingelheim, Bristol-Myers Squibb, Genfit, Gilead, Intercept, Ipsen, Janssen, Madrigal, Mirum, MSD, Novartis, Phenex, Pliant, ProQR Therapeuics, Regulus, and Shire, and received travel support from AbbVie, Falk Foundation, Gilead, and Intercept, as well as grants\/research support from Albireo, Alnylam, Cymabay, Falk, Genfit, Gilead, Intercept, MSD, Takeda, and UltraGenyx. He is also co-inventor of patents on the medical use of 24-norursodeoxycholic acid filed by the Medical Universities of Graz and Vienna. M.\u00a0Mandorfer served as a\u00a0speaker and\/or consultant and\/or advisory board member for AbbVie, Collective Acumen, Gilead, Takeda, and W. L. Gore & Associates and received travel support from AbbVie and Gilead. T.\u00a0Reiberger served as a\u00a0speaker and\/or consultant and\/or advisory board member for AbbVie, Bayer, Boehringer Ingelheim, Gilead, Intercept, MSD, Siemens, and W. L. Gore & Associates and received grants\/research support from AbbVie, Boehringer Ingelheim, Gilead, Intercept, MSD, Myr Pharmaceuticals, Pliant, Philips, Siemens, and W. L. Gore & Associates as well as travel support from AbbVie, Boehringer Ingelheim, Gilead and Roche. L.\u00a0Hartl received travel support from Abbvie.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}