This is the American Association for the Study of Liver Diseases (AASLD) comprehensive guideline on the application of endovascular interventional radiological procedures in the treatment of variceal bleeding, which supplements Risk Stratification and Management of Portal Hypertensive Bleeding in Cirrhosis by describing recent advances in invasive surgery. Transjugular intrahepatic portosystemic shunt (TIPS) dates back to the 80s of the 20th century, and over the past few years, several new technical improvements have been made to TIPS stents. Another major treatment for gastric variceal bleeding in North America is the use of different forms of retrograde transvenous embolization. This guideline is intended to provide healthcare professionals with an in-depth understanding of the use of TIPS and/or variceal embolization/occlusion in the treatment of variceal bleeding, with the goal of facilitating multidisciplinary discussions on treatment strategies among hepatologists, gastroenterologists, interventional radiologists, and surgeons. Additionally, it provides a data-based approach to the endovascular treatment of variceal bleeding. However, it differs from the AASLD guidelines by being supported by a systematic review of the literature, a formal rating of the quality of the evidence, and the strength of the recommendations. Consequently, this guideline was developed by a consensus of an expert panel under the supervision of the AASLD Practice Guidelines Committee and provides guidance statements based on a comprehensive review and analysis of the literature on the relevant topic. Importantly, the AASLD Practice Guidelines Committee selected this topic because, for the most part, there are not a sufficient number of randomized controlled trials on this topic to provide meaningful systematic reviews and meta-analyses.
该指南是美国肝病研究学会（AASLD）关于介入放射血管内技术在曲张静脉出血治疗应用中的综合指南，是对AASLD\"肝硬化门静脉高压出血风险分层和管理\"指南的补充，阐述了侵入性手术的最新进展。经颈静脉肝内门体分流术（TIPS）可追溯到20世纪80年代，在过去的几年里，TIPS支架进行了一些新的技术改进。在北美，胃静脉曲张出血的另一个主要治疗方法是采用不同形式的逆行性经静脉栓塞术。该指南旨在使医护人员深入了解TIPS和/或曲张静脉栓塞/闭塞术在曲张静脉出血治疗中的应用，目的是促进肝病科、胃肠病科、介入放射科和外科之间在治疗策略上的多学科讨论。该指南为曲张静脉出血的血管内治疗提供了基于数据支持的方法。它不同于AASLD指南由文献的系统评价、证据质量的正式评级和建议的强度来支持。该指南在AASLD实践指南委员会的监督下，由专家小组达成共识，基于对相关主题文献的全面审查和分析提出指导性声明。AASLD实践指南委员会之所以选择该主题，是因为大多数情况下，在该主题上没有足够数量的随机对照试验提供有意义的系统综述和荟萃分析。.

The Billroth IV consensus was developed during a consensus meeting of the Austrian Society of Gastroenterology and Hepatology (ÖGGH) and the Austrian Society of Interventional Radiology (ÖGIR) held on the 26th of November 2022 in Vienna.Based on international recommendations and considering recent landmark studies, the Billroth IV consensus provides guidance regarding the diagnosis and management of portal hypertension in advanced chronic liver disease.

Portal hypertension is a complication of chronic liver disease. Various radiological interventions are being done to aid in the diagnosis of portal hypertension; further, an interventional radiologist can offer various treatments for the complications of portal hypertension. Diagnosis of portal hypertension in its early stage may require hepatic venous pressure gradient measurement. Measurement of gradient also guides in diagnosing the type of portal hypertension, measuring response to treatment and prognostication. This article attempts to provide evidence-based guidelines on the management of portal hypertension and treatment of its complications.

门静脉血栓是肝硬化常见的严重并发症之一。当前，国内外尚无专门针对肝硬化门静脉血栓管理的指南或共识。本专家共识基于最新研究证据及国内专家共识意见，系统阐述了肝硬化门静脉血栓的流行病学、危险因素、影像学检查、诊断、病情评估以及治疗策略，以进一步规范临床诊疗实践。.

Portal hypertension(PH) is one of the main complications of cirrhosis.Transjugular intrahepatic portosystemic shunt(TIPS) is the percutaneous creation of a conduit from the hepatic vein to the portal vein that is used to manage consequences of PH (i.e., variceal bleeding and refractory ascites) and used as a bridging therapy to liver transplant for decompensated cirrhosis. The following Clinical Practice Guidelines (CPGs) presents profession associational recommendations of the Chinese College of Interventionalists(CCI) on TIPS for PH. The CPGs was written by more than 30 experts in the field of TIPS in China (including interventional radiologists, liver surgeons, hepatologists and gastroenterologist, et al.). The panel of experts, produced these CPGs using evidence from PubMed and Cochrane database searches and combined with relevant expert consensuses and high quality clinical researches in China providing up to date guidance on TIPS for PH with the only purpose of improving clinical practice.
门静脉高压是肝硬化的主要并发症之一。经颈静脉肝内门体分流术（TIPS）是通过在肝静脉与门静脉之间的肝实质内建立分流道治疗门静脉高压相关并发症（如食管胃静脉曲张破裂出血、顽固性腹水等）的技术，也可作为肝硬化失代偿期患者等待肝移植期间的桥接治疗手段。本临床实践指南提出了中国医师协会介入医师分会（CCI）关于门静脉高压TIPS治疗的推荐意见，由我国30多位TIPS领域的专家（包括放射介入科、肝胆外科、肝病科及消化科等）使用PubMed和Cochrane数据库搜索提供的研究证据和国内相关专家共识及高质量临床研究编写而成，为门静脉高压TIPS治疗提供了最新的指导，其唯一目的是提高我国TIPS临床实践水平。.