Transmesenteric portosystemic shunt achieves high patency in cavernous portal vein transformation

In 70 patients with cavernous transformation of the portal vein, transmesenteric extrahepatic portosystemic shunt (TmEPS) achieved 100% technical success, dropping mean portal pressure gradient from 21.9 to 10.6 mmHg (p<0.001), with 36-month stent patency of 86% — retrospective,…

• Single-center retrospective study (n=70; mean age 55.6 years); median follow-up only 11 months (range 5–27.5 months), limiting long-term conclusions.
• Cumulative survival was 85%, 79%, and 74% at 12, 24, and 36 months; hepatic encephalopathy developed in 14% at 12 months and 23% at 24–36 months — a rate worth monitoring given this is a non-TIPS shunt approach.
• No comparator group and no external validation; results apply to selected patients at a single high-volume center, so generalizability is uncertain.

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