Publication Name	World Journal of Gastrointestinal Surgery
Manuscript ID	125867
DOI	10.4240/wjgs.125867
Country	China

Category	Gastroenterology & Hepatology
Manuscript Type	Prospective Study
Article Title	Transfemoral inferior vena cava–splenic vein shunt: A proof-of-concept alternative to transjugular intrahepatic portosystemic shunt
Manuscript Source	Unsolicited Manuscript
All Author List	Jing-Qiu Zhang, Xin-Jian Xu, Chun-Ze Zhou, Liang Yin, Yi-Jiang Zhu, Ning Wei, Lei Hu and De-Lei Cheng
Funding Agency and Grant Number	Funding Agency Grant Number Natural Science Foundation of Hefei 202341 Research Project of Anhui Provincial Health Committee AHwj2023a20508
Corresponding Author	De-Lei Cheng, MD, Professor, Department of Interventional Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 17 Lujiang Rd, Hefei 230000, Anhui Province, China. chengdelei@hotmail.com
Key Words	Transfemoral inferior vena cava–splenic vein shunt; Transjugular intrahepatic portosystemic shunt; Hepatic Encephalopathy; Portal venous system; Ammonia
Core Tip	This study presents transfemoral inferior vena cava–splenic vein shunt (TIVSS) as a potential novel alternative to transjugular intrahepatic portosystemic shunt (TIPS) for cirrhotic patients, aiming to reduce the risk of hepatic encephalopathy in such patients. Using both clinical and animal models, we demonstrated there was an ammonia gradient in the portal venous system, wherein the splenic vein carries the lowest ammonia levels. We also showed that TIVSS could effectively shunt low-ammonia blood, stabilizing systemic ammonia levels postoperatively, in contrast to TIPS, which often results in significant hyperammonemia. Initial experimental tests suggest TIVSS is promising and warrants further investigation.
Citation	Zhang JQ, Xu XJ, Zhou CZ, Yin L, Zhu YJ, Wei N, Hu L, Cheng. DL Transfemoral inferior vena cava–splenic vein shunt: A proof-of-concept alternative to transjugular intrahepatic portosystemic shunt. World J Gastrointest Surg 2026; In press DOI: https://doi.org/10.4240/wjgs.125867
PDF	125867-in-press.pdf

Received	2026-07-20 07:09
Peer-Review Started	2026-07-20 07:10
First Decision by Editorial Office Director
Return for Revision	2026-08-24 02:10
Revised	2026-09-06 17:38
Publication Fee Transferred	2026-09-23 12:18
Second Decision by Editor	2026-11-12 06:08
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-11-12 09:59
Articles in Press	2026-11-12 09:59
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-9366 (online)
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