{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T19:35:23Z","timestamp":1762544123939,"version":"3.40.4"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare the long\u2010term efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) combined with concurrent antegrade embolization in treating portal hypertension with oesophagogastric variceal bleeding in patients with and without large spontaneous portosystemic shunts (L\u2010SPSSs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We retrospectively analysed data from patients with portal hypertension who underwent TIPS from November 2015 to April 2022. The patients were screened according to the inclusion criteria and were divided into L\u2010SPSSs group (L\u2010S group) and Non L\u2010SPSSs group (Non L\u2010S group). The primary outcome was the 2\u2010year liver transplantation\u2010free survival (TFS) rate. Secondary outcomes contained the incidence of overt hepatic encephalopathy (OHE), ectopic embolization and the 2\u2010year rebleeding rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 259 patients were enrolled (64 patients in L\u2010S group and 195 patients in Non L\u2010S group). The average age was 57.2\u2009years, and the success rate of procedure was 100%. Baseline data showed no significant differences between two groups. There was a statistically significant difference in the 2\u2010year liver transplantation\u2010free rate between two groups (L\u2010S vs. Non L\u2010S, 84.38% vs. 71.28%; <jats:italic>p<\/jats:italic>\u2009=\u20090.045). OHE occurred in 19 (29.69%) patients with L\u2010SPSSs and 104 (53.33%) patients without L\u2010SPSSs, with a statistically significant difference (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). And no statistically significant difference was found in ectopic embolism incidence rate and the 2\u2010year rebleeding rate between two groups. Multivariate Cox regression analysis identified male gender, portal vein thrombosis and preoperative high blood ammonia levels as independent risk factors for long\u2010term survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared to Non L\u2010S group, the patients in L\u2010S group achieve longer liver transplantation\u2010free survival and lower incidence rate of OHE without increasing the risk of 2\u2010year rebleeding and ectopic embolization.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1754-9485.13832","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T12:19:51Z","timestamp":1740140391000},"page":"228-236","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of the Efficacy and Safety of Transjugular Intrahepatic Portosystemic Shunt Combined With Concurrent Antegrade Embolization of Large Spontaneous Portosystemic Shunts"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7821-7035","authenticated-orcid":false,"given":"Ze","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Interventional Radiology The First Affiliated Hospital of Soochow University  Suzhou People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao\u2010Yang","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology The First Affiliated Hospital of Soochow University  Suzhou People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen\u2010You","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology The First Affiliated Hospital of Soochow University  Suzhou People's Republic of 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