{
  "abstract": "Thrombotic occlusion of a transjugular intrahepatic portosystemic shunt (TIPS) returns the patient to the portal-hypertensive state prior to shunt creation and requires early recognition and intervention. We describe a 45-year-old woman with metabolic dysfunction-associated steatohepatitis (MASH) cirrhosis who underwent TIPS placement for refractory ascites with subsequent clinical improvement. Approximately two months later, she presented with progressive anasarca, bilateral lower-extremity edema, abdominal distension, and diffuse abdominal pain. Computed tomography (CT) and Doppler ultrasound demonstrated complete in-stent shunt thrombosis, cirrhotic morphology, and moderate ascites. She was started on therapeutic heparin and underwent transjugular TIPS recanalization with large-bore mechanical aspiration thrombectomy followed by balloon angioplasty directed at the hepatic venous outflow segment. Completion venography demonstrated restored flow through the shunt without residual stenosis or obstruction; the portosystemic pressure gradient decreased from 21 to 13 mmHg. Her abdominal pain and manifestations of volume overload improved, and she was discharged on apixaban. This case demonstrates that single-session large-bore aspiration thrombectomy combined with balloon angioplasty can achieve technical, hemodynamic, and early clinical success in symptomatic early TIPS occlusion. Further studies are needed to determine its long-term efficacy and optimal role in TIPS revision.",
  "abstract_shown": true,
  "affiliations": [
    "Radiology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA.",
    "Internal Medicine, HCA Florida Blake Hospital, Bradenton, USA."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Renato Abu Hana"
    },
    {
      "affs": [
        0
      ],
      "name": "Ryosuke Miyauchi"
    },
    {
      "affs": [
        1
      ],
      "name": "Yusuf Alzoubi"
    },
    {
      "affs": [
        0
      ],
      "name": "Grit A Adler"
    },
    {
      "affs": [
        0
      ],
      "name": "Vinicius Adami Vayego Fornazari"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7zdb5qbvqf106.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.116837",
  "fulltext_url": "https://europepmc.org/articles/PMC13695505",
  "id": "7zdb5qbvqf106",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://europepmc.org/article/MED/42927397",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2721|Liver Disease and Transplantation"
    ]
  ],
  "openalex": "W7214149540",
  "pdf_url": "https://europepmc.org/articles/PMC13695505?pdf=render",
  "pmcid": "PMC13695505",
  "pmid": "42927397",
  "published": "2026-09-24",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7zdb5qbvqf106.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:18Z",
      "native_id": "MED:42927397",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42927397"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2721|Liver Disease and Transplantation",
      "subfield": "general"
    }
  ],
  "title": "Clot Out, Flow Back: Large-Bore Aspiration Thrombectomy for Symptomatic Early Transjugular Intrahepatic Portosystemic Shunt (TIPS) Occlusion.",
  "title_text": "Clot Out, Flow Back: Large-Bore Aspiration Thrombectomy for Symptomatic Early Transjugular Intrahepatic Portosystemic Shunt (TIPS) Occlusion.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:18Z",
  "url": "https://research.draconitic.com/paper/7zdb5qbvqf106",
  "venue": "Cureus",
  "versions": []
}