Transjugular Intrahepatic Portosystemic Shunt for Advanced Hepatocellular Carcinoma With Main Portal Vein Tumor Thrombus-Related Symptomatic Portal Hypertension

• Published in: Journal of clinical and experimental hepatology 2024-03, Vol.14 (2), p.101305, Article 101305
• Main Authors: Xie, Yong, Lyu, Tianshi, Song, Li, Tong, Xiaoqiang, Wang, Jian, Zou, Yinghua
• Format: Article
• Language: English
• Subjects: hepatocellular carcinoma; p classification; portal vein tumor thrombus; symptomatic portal hypertension; transjugular intrahepatic portosystemic shunt
• ISSN: 0973-6883; 2213-3453
• DOI: 10.1016/j.jceh.2023.101305

The safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of symptomatic portal hypertension (SPH) caused by hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) of main trunk remains unclear. The purpose of this study was to initially explore the safety and efficacy of TIPS for SPH caused by HCC with PVTT of main trunk. This retrospective study analyzed 16 patients who underwent TIPS for SPH caused by HCC with PVTT of main trunk. The evaluated outcomes were technical success rate, SPH control rate, stent patency rate, overall survival (OS), and complications. From July 2018 to February 2023, sixteen consecutive HCC patients with PVTT of main trunk and SPH were retrospectively identified. Technical success was 93.75 %. All patients had complete or partial remission of clinical symptoms, and there were no incidents of acute variceal rebleeding and re-exacerbation of ascites during follow-up. There had no intraoperative TIPS-related complications occurred. One patient developed mild hepatic encephalopathy after TIPS placement during the follow-up period. During follow-up, 13 of 16 patients died of advanced HCC progression, the median OS was 10.0 months, and the cumulative OS of 0.5-, 1-, and 2 years were 66.67 %, 45.00 %, and 11.25 %, respectively. TIPS for SPH caused by HCC with PVTT of main trunk may be safe and effective. [Display omitted] •This retrospective study analyzed 16 patients, from July 2018 to February 2023, who underwent TIPS for SPH caused by HCC with PVTT of main trunk.•All patients had complete or partial remission of clinical symptoms, and there were no incidents of acute variceal rebleeding and re-exacerbation of ascites during follow-up.•During follow-up, 13 of 16 patients died of advanced HCC progression, the median OS was 10.0 months, and the cumulative OS of 0.5-, 1-, and 2 years were 66.67 %, 45.00 %, and 11.25 %, respectively.•TIPS for SPH caused by HCC with PVTT of main trunk may be safe and effective.