Combined transjugular intrahepatic portosystemic shunt and other interventions for hepatocellular carcinoma with portal hypertension

Figure 1 Patient with hepatitis C cirrhosis associated with esophageal gastric-fundus variceal bleeding was diagnosed with hepatocellular carcinoma 37 mo after transjugular intrahepatic portosystemic shunt. We treated HCC with TACE. A: Obvious portal vein dilation (white arrow) revealed by magnetic resonance cholangiopancreatography; B1: Obvious portal vein dilation (short white arrow) and gastric coronary vein varicosis (long white arrow); B2: Gastric coronary vein embolism (long white arrow) and distributary channel (short white arrow); C: Tumor lesion with rich blood supply in the right hepatic lobe 37 mo after TIPS by hepatic angiography (white arrow); D: Iodine oil deposited in the lesion after TACE, shown by contrast-enhanced CT (white arrow). HCC: Hepatocellular carcinoma; TACE: Transarterial chemoembolization; TIPS: Transjugular intrahepatic portosystemic shunt; CT: Computed tomography.

Figure 2 Patient with hepatitis B cirrhosis was diagnosed with hepatocellular carcinoma, refractory ascites, and esophageal gastric-fundus variceal bleeding. Patient underwent TACE after TIPS. A: Tumor lesion revealed by contrast-enhanced CT arterial phase (white arrow). B1: Obvious portal vein dilation (short white arrow) and gastric coronary vein varicosis (long white arrow). B2: Gastric coronary vein embolism (long black arrow) and distributary channel (short black arrow). C: Lodine oil deposited in the lesion after TACE, shown by CT (black arrow); ascites disappeared and distributary channel stent (white arrow). TACE: Transarterial chemoembolization; TIPS: Transjugular intrahepatic portosystemic shunt; CT: Computed tomography.

Figure 3 Survival functions of all patients by Kaplan-Meier survival curves.