Abstract
<title>Abstract</title> <p>Purpose To analyze the safety of transjugular intrahepatic portosystemic shunt alone and transjugular intrahepatic portosystemic shunt plus thrombectomy for portal vein thrombosis. Materials and Methods A retrospective study including 38 transjugular intrahepatic portosystemic shunt creation for patients with portal vein thrombosis between January 2022 and December 2025 was performed at a single academic center. Baseline demographics and labs were collected. 21 of these patients had thrombectomy. The mean fluoroscopy time, total procedure time, bleeding complications, hepatic encephalopathy, overall survival and stent patency were evaluated. An independent T-test was performed to compare the means of nominal variables. The Chi Square Test used to compare categorical variables. Kaplan Meier curves with Log Rank test were performed to assess overall survival and stent patency over a maximum follow up of 12 months Results Demographics and baseline labs were not significantly different between the two groups. 78.6% of patients with Yerdel I portal vein thrombosis received transjugular intrahepatic portosystemic shunt alone, while 88.9% of patients with Yerdel IV received thrombectomy together (p=.005). There was no significant difference in mean fluoroscopy time (45.96 min vs 52.28 min, p=.316), total procedure time (149.25 min vs 171.33 min, p=.381), bleeding complication (0% vs 9.5%, p=.315), post-procedure hepatic encephalopathy (29.4% vs 38.1%, p=.666), overall survival (p=.063) and stent patency (87.5% vs 63%, p=.132). Conclusion Our analysis suggests that transjugular intrahepatic portosystemic shunt plus thrombectomy in patients with severe thrombosis burden is comparable to transjugular intrahepatic portosystemic shunt alone in safety aspects with low rates of adverse events.</p>