Combined TIPS and TACE for patients with hepatocellular carcinoma and variceal bleeding secondary to portal vein tumor thrombus.
- 1Department of Interventional Radiology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, 210029, China.
- 2Department of Interventional Radiology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, 210029, China. [email protected].
- 3Department of Interventional Radiology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, 210029, China. [email protected].
Abstract
Purpose
The study aimed to assess the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with transarterial chemoembolization (TACE) for treating hepatocellular carcinoma (HCC) patients who have portal vein tumor thrombus (PVTT) and variceal bleeding secondary to portal hypertension.Methods
This retrospective study analysed 39 patients with HCC and PVTT who experienced variceal bleeding and were treated with TIPS and TACE from June 2018 to April 2025. The evaluated outcomes included the technical success, clinical success and overall survival (OS).Results
The technical success rate was 100%. Variceal bleeding was successfully controlled in all patients. Among these patients, 13 (33.3%) developed overt hepatic encephalopathy (HE) after TIPS. There were no other significant procedure-related complications. The recurrence rate of variceal bleeding was 25.6% at 1 year. After TACE, all patients exhibited a reduction in tumor size, with 26 (66.7%) patients achieving partial response (PR) and 13 (33.3%) patients achieving stable disease (SD). The median OS was 12.2 (95% CI: 10.9-13.5) months and OS rates were 89.7% at 1 month, 76.9% at 3 months, 56.4% at 6 months, and 46.2% at 12 months.Conclusion
TIPS combined with TACE appears to be safe and effective for patients who had HCC and PVTT complicated with variceal bleeding secondary to portal hypertension.Clinical significance
This study found that the combination of TIPS and TACE is a safe and effective treatment for patients with HCC and PVTT. The treatment successfully stopped the bleeding in all patients, helped shrink the tumors in most, and improved overall survival. This approach not only manages the life-threatening bleeding but also allows for further treatment of the liver cancer itself.
Related
- Acute colonic variceal bleeding treated with coil-assisted retrograde transvenous obliteration following atezolizumab-bevacizumab therapy for advanced hepatocellular carcinoma: A case report.
- Sleep Disturbance and Associated Factors in Hepatocellular Carcinoma Patients Receiving HAIC Combined with Immunotherapy and Targeted Therapy: A Cross-Sectional Study
- The Efficacy and Safety of Combined Locoregional and Systemic Therapy versus Systemic Therapy Alone in Patients with Hepatocellular Carcinoma and Portal Vein Tumor Thrombosis: A Multicenter Real-World Retrospective Cohort Study.
- Platelet count combined with Child-Turcotte-Pugh score for predicting rebleeding in cirrhotic patients with esophagogastric variceal bleeding
- Survival outcomes of spleen-strengthening and dampness-eliminating traditional Chinese medicine granules combined with lenvatinib for unresectable hepatocellular carcinoma: a large-sample retrospective study based on electronic medical records
BibTeX
@article{feng2026combined,
title = {{Combined TIPS and TACE for patients with hepatocellular carcinoma and variceal bleeding secondary to portal vein tumor thrombus.}},
author = {Zhuyu Feng and Bifei Wu and Zhongwei Xu and Wei Yang and Haifeng Zhou and Haibin Shi and Sheng Liu and Weizhong Zhou},
journal = {BMC gastroenterology},
year = {2026},
month = jul,
doi = {10.1186/s12876-026-05100-0},
url = {https://europepmc.org/article/MED/42902152},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Combined TIPS and TACE for patients with hepatocellular carcinoma and variceal bleeding secondary to portal vein tumor thrombus.
AU - Zhuyu Feng
AU - Bifei Wu
AU - Zhongwei Xu
AU - Wei Yang
AU - Haifeng Zhou
AU - Haibin Shi
AU - Sheng Liu
AU - Weizhong Zhou
PY - 2026
DA - 2026/07/01
JO - BMC gastroenterology
DO - 10.1186/s12876-026-05100-0
UR - https://europepmc.org/article/MED/42902152
AB - Purpose The study aimed to assess the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with transarterial chemoembolization (TACE) for treating hepatocellular carcinoma (HCC) patients who have portal vein tumor thrombus (PVTT) and variceal bleeding secondary to portal hypertension.Methods This retrospective study analysed 39 patients with HCC and PVTT who experienced variceal bleeding and were treated with TIPS and TACE from June 2018 to April 2025. The evaluated outcomes included the technical success, clinical success and overall survival (OS).Results The technical success rate was 100%. Variceal bleeding was successfully controlled in all patients. Among these patients, 13 (33.3%) developed overt hepatic encephalopathy (HE) after TIPS. There were no other significant procedure-related complications. The recurrence rate of variceal bleeding was 25.6% at 1 year. After TACE, all patients exhibited a reduction in tumor size, with 26 (66.7%) patients achieving partial response (PR) and 13 (33.3%) patients achieving stable disease (SD). The median OS was 12.2 (95% CI: 10.9-13.5) months and OS rates were 89.7% at 1 month, 76.9% at 3 months, 56.4% at 6 months, and 46.2% at 12 months.Conclusion TIPS combined with TACE appears to be safe and effective for patients who had HCC and PVTT complicated with variceal bleeding secondary to portal hypertension.Clinical significance This study found that the combination of TIPS and TACE is a safe and effective treatment for patients with HCC and PVTT. The treatment successfully stopped the bleeding in all patients, helped shrink the tumors in most, and improved overall survival. This approach not only manages the life-threatening bleeding but also allows for further treatment of the liver cancer itself.
SN - 1471-230X
ER -