
A recent study validates the effectiveness of transjugular intrahepatic portosystemic shunt (TIPS) combined with extrahepatic collateral embolization (TIPS+E) in reducing rebleeding and hepatic encephalopathy (HE) post-TIPS. Real-world data analysis involving 1136 matched patients showed TIPS+E significantly reduced rebleeding, HE, and further decompensation (FDC) compared to TIPS alone. TIPS+E was particularly effective when using 8 mm diameter stents and embolizing gastric varices + spontaneous portosystemic shunts (GV+SPSS). Survival rates didn't differ significantly. The study emphasizes controlling post-TIPS portal pressure gradient (pPPG) within 7-8.5 mm Hg for improved outcomes, especially with TIPS+E.
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