Portosystemic shunting (TIPS procedure) in patient with risk of recurrent portal variceal bleeding against the background of unstable angina

Antithrombotic therapy in patients with unstable angina is considered mandatory. However, in patients with concomitant cirrhotic portal hypertension, complicated by previously occurring variceal esophagogastric bleeding, the prescription of anticoagulants and antiplatelet agents negatively affects the effectiveness of hemostatic measures in case of recurrent hemorrhage and can lead to poor outcome.Case report demonstrates result of TIPS procedure, supplemented by embolization of inflow tracts to the esophagogastric varices in a patient with an endoscopically established high risk of variceal re-bleeding against the background of coronary heart disease with unstable angina. Achieving effective portal decompression made it possible to prescribe the patient antithrombotic therapy, subsequently perform coronary stenting and continue the necessary therapy with a good long-term outcome in the course of both diseases.Of total number of 307 patients with complicated portal hypertension who underwent TIPS procedure in Surgical clinic of Rostov State Medical University in 2007-23, in 27 patients portosystemic shunt intervention was performed against the background of the need for antithrombotic therapy due to comorbid pathology.