查看文章

In general, TIPS is the preferred technique over PSE for variceal hemorrhage secondary to portal hypertension. However, PSE in combination with balloon occlusion retrograde alcohol embolization can be particularly useful in cases such as splenic vein thrombosis where TIPS may not be effective. 10 It can also be used as an alternative to TIPS if the portal and hepatic venous anatomy is so distorted that TIPS becomes technically difficult. PSE has also been used for other portal hypertension complications, such as portal hypertensive enteropathy or impaired hepatic function. 1, 10

CONTRAINDICATIONS PSE causes decreased portal venous flow, which, in combination with an increase in platelet count, can cause portal or splenic vein thrombosis. 11, 12 Hepatofugal flow should be considered a contraindication to PSE. Other relative contraindications include severe infection, abnormal coagulation status, and decompensated liver disease in its terminal stage.