{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T16:18:43Z","timestamp":1787415523273,"version":"build-2736575974"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T00:00:00Z","timestamp":1712620800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T00:00:00Z","timestamp":1712620800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003995","name":"Natural Science Foundation of Anhui Province","doi-asserted-by":"publisher","award":["2108085MH302"],"award-info":[{"award-number":["2108085MH302"]}],"id":[{"id":"10.13039\/501100003995","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018628","name":"Scientific Research Foundation of Education Department of Anhui Province of China","doi-asserted-by":"publisher","award":["2022AH040189"],"award-info":[{"award-number":["2022AH040189"]}],"id":[{"id":"10.13039\/501100018628","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hepatol Int"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Performing 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 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\u2009\u00b1\u20093.19\u00a0mmHg vs. 11.48\u2009\u00b1\u20091.74\u00a0mmHg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01).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\u00a0months, spanning a range of 5 to 39\u00a0months, 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Precision-guided TEPS appears to be a safe and efficacious intervention for the management of CTPV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12072-024-10656-8","type":"journal-article","created":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T13:01:40Z","timestamp":1712667700000},"page":"1227-1237","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["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"],"prefix":"10.1007","volume":"18","author":[{"given":"Liu","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Jiang","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue-qing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui-feng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Fu","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"De-Lei","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3465-1162","authenticated-orcid":false,"given":"Chun-Ze","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,9]]},"reference":[{"issue":"12","key":"10656_CR1","doi-asserted-by":"publisher","first-page":"2156","DOI":"10.1136\/gutjnl-2017-314634","volume":"67","author":"Y Lv","year":"2018","unstructured":"Lv Y, Qi X, He C, et al. Covered TIPS versus endoscopic band ligation plus propranolol for the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis: a randomized controlled trial. Gut. 2018;67(12):2156\u20132168","journal-title":"Gut"},{"issue":"1","key":"10656_CR2","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1148\/radiol.15141252","volume":"276","author":"X Luo","year":"2015","unstructured":"Luo X, Wang Z, Tsauo J, et al. Advanced cirrhosis combined with portal vein thrombosis: a randomized trial of tips versus endoscopic band ligation plus propranolol for the prevention of recurrent esophageal variceal bleeding. Radiology. 2015;276(1):286\u2013293","journal-title":"Radiology"},{"issue":"2","key":"10656_CR3","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1111\/1751-2980.12702","volume":"20","author":"LN Li","year":"2019","unstructured":"Li LN, Sun XY, Wang GC, et al. Transjugular intrahepatic portosystemic shunt prevents rebleeding in cirrhotic patients having cavernous transformation of the portal vein without improving their survival. J Dig Dis. 2019;20(2):89\u201396","journal-title":"J Dig Dis"},{"issue":"12","key":"10656_CR4","doi-asserted-by":"publisher","first-page":"3431","DOI":"10.1007\/s00330-015-3777-1","volume":"25","author":"Y Chen","year":"2015","unstructured":"Chen Y, Ye P, Li Y, et al. Percutaneous transhepatic balloon-assisted transjugular intrahepatic portosystemic shunt for chronic, totally occluded, portal vein thrombosis with symptomatic portal hypertension: procedure technique, safety, and clinical applications. Eur Radiol. 2015;25(12):3431\u20133437","journal-title":"Eur Radiol"},{"issue":"2","key":"10656_CR5","first-page":"90","volume":"6","author":"W Li","year":"2023","unstructured":"Li W, Cui M, Li Q, et al. 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Yi-Jiang Zhu has no conflict of interest. Xue-qing Wang has no conflict of interest. Rui-feng Wang has no conflict of interest. Li Dong has no conflict of interest. Liang Yin has no conflict of interest. Wei-Fu Lv has no conflict of interest. De-Lei Cheng has no conflict of interest. Chun-Ze Zhou has no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}