To investigate the clinical efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with catheter-directed thrombus aspiration in the treatment of symptomatic portal vein thrombosis (PVT).

A retrospective analysis was performed on the clinical data of 13 patients with symptomatic portal vein thrombosis who underwent TIPS combined with catheter-directed thrombus aspiration at Huai′an First Hospital Affiliated to Nanjing Medical University from March 2020 to December 2023.The surgical success rate, postoperative changes in portal vein pressure, resolution of portal vein thrombosis, improvement of esophagogastric varices and ascites were observed.

TIPS combined with catheter-directed thrombus aspiration was successfully performed in all 13 patients (100%).The postoperative portal vein pressure decreased significantly compared with the preoperative level [(17.51±4.94) mmHg vs. (24.60±5.81) mmHg], with a statistically significant difference (P<0.05). During a mean postoperative follow-up period of 16 months, the complete recanalization rate of thrombosis was 76.9% (10/13), the remission rate of esophagogastric varices was 69.2% (9/13), and the improvement rate of ascites was 71.4% (5/7).The incidence of postoperative hepatic encephalopathy was 23.1%(3/13).No severe complications such as abdominal hemorrhage or acute liver failure occurred in any of the patients.

TIPS combined with catheter-directed thrombus aspiration yields a high success rate and favorable clinical efficacy in the treatment of patients with symptomatic portal vein thrombosis, which is worthy of clinical promotion.