*UPDATE* New Non-surgical Procedure for PVT (PVR-TIPS)

PLEASE NOTE:  Since my original post (March 13/20) I would like to reiterate that this relatively new procedure is indeed helping people with the right physical criteria and it not always suitable for everyone.  The results for those who have had the procedure are quite astounding though as you can read from the comments I have received so far.  On my post called “My Portal Hypertension Journey” a friend (Greg) who I met since I started this blog, just posted his own personal success story after suffering for 40 years with the condition.  I have reposted his comments at the end of this post as it was through Dr. Salem and his team that Greg’s condition has been reversed.  October 27/20

With great optimism I share this news with you today.  Dr. Riad Salem at Northwestern University in Chicago Illinois, and a team of over a dozen doctors have recently developed and tested a new non-surgical procedure for the treatment of portal vein thrombosis (PVT).

A few days ago Dr. Salem reached out to me via this blog with the results of the clinical study.   His words below encapsulate this new technique.   

“At Northwestern, we have pioneered a new, non-surgical approach for the treatment of portal vein thrombosis with or without cavernomatous transformation.  It involves creating a new channel in the clotted portal vein, and placing a transjugular intrahepatic portosystemic shunt (TIPS) stent. We do this using ultrasound and X-ray guidance. Our first series of 61 patients has already been published with excellent success, and many of these patients have gone on to liver transplantation since they had cirrhosis of the liver. We are now performing this on adults without cirrhosis with cavernoma. Some of these patients have varices that have bled. This is a procedure you should be evaluated for if you are considering a Rex shunt or any other interventianal operation since this is a less evasive alternative”.

Contact Information

Riad Salem MD MBA
Professor of Radiology, Medicine and Surgery
Chief, Section of Vascular and Interventional Radiology
Vice-Chairman, Image-Guided Therapy
Department of Radiology
Northwestern University
676 N St Clair, Suite 800
Chicago, IL USA 60611
1-312-695-6371 office

Dr. Salem is glad to answer questions for patients and has asked that you contact him directly at rsalem1@nm.org 

If you have a story to share about your personal journey with portal hypertension or have had the procedure please feel free to post it. 

Addendum comment posted October 26/20 as mentioned above: 

“Thank you, Clint for providing a valuable conduit for information regarding PVT for patients and their families with PVT.

I have had PVT since birth, and as a consequence, have experienced 2 major bleeds from my esophageal varicies when I was in high school. As a lifesaving measure to decompress my esophageal varicies, I had a Splenorenal shunt created to prevent future bleeds. I was blessed to have been put under the care of two distinguished physicians and exemplary individuals: Gastroenterologist, Dr. William Baldus, and surgeon, Dr. Martin Adson, both doctors at the Mayo Clinic.

I began to experience the gradual onset of hepatic encephalopathy in my mid 30’s. As I have aged (now 57) I have had a growing list of health issues tied to PVT. Although I have not had any banding of my varicies done for few years now, I still have esophageal and gastric varicies.

I am writing this entry because I now feel a sense of hope for me and my family. I am grateful to Dr. Riad Salem, another distinguished physician and exemplary person who is an interventional radiologist at Northwestern University Medical Center in Chicago. Dr. Salem was able to place a stent in and through what was the cavernous transformation of my portal vein and and connect my atrophied liver with an entirely new supply of blood from the nexus of my Inferior vena cava and splenic vein. The initial transformation was very significant, and I continue to do well. It is my understanding that improvement in the symptoms of PVT and hepatic encephalopathy as my body adjusts to this welcome change.

Dr. Salem, his colleagues and staff at Northwestern University are among the best of the best. After surgeons attempted a REX shunt on me at another institution in 1979, albeit unsuccessfully because of the atrophied condition of my liver, I was resigned to the prospect that I would never experience the benefit of an open portal vein. Dr. Salem and his colleagues have helped me and many others realize the many benefits of an open portal vein”.

“If you can’t fly then run, if you can’t run then walk, if you can’t walk then crawl, but whatever you do you have to keep moving forward”.  – Martin Luther King Jr.


42 thoughts on “*UPDATE* New Non-surgical Procedure for PVT (PVR-TIPS)

  1. Ahmed

    Clint, I want to thank you for posting this information about the work Dr. Salem and his team are doing at Northwestern. I have non-cirrhotic PVT with cavernous transformation and I was desperately looking for treatment that could give me a normal life back. I got in touch with Dr. Salem after reading the post and we started discussing my condition and medical history. After sending him copies of my latest imaging, Dr. Salem wanted me to fly to Chicago for the PVR-TIPS procedure, which I did. The procedure was a success and Dr. Salem restored blood flow to my portal and mesenteric veins and embolize my varices to reduce my risk of bleeding. I’m finally off the beta blocker that was draining all my energy away. I feel much better and I’m looking forward to the follow ups over the next few months to see how my body is reacting and hopefully resolving the remaining clotting in my portal and mesenteric veins.

    I encourage anyone with PVT to contact Dr. Salem to evaluate if they are a good candidate for this procedure. The procedure and treatment I received Northwestern has really changed my outlook on life and my hope to enjoy a healthy and normal life with my family.

    1. Clint Post author

      Thank you! This truly is good news! How did have you PVT before the procedure? Dr.Salem has also offered to look at my tests, but there are a few more considerations to be made before I can pursue this option. I have a colonoscopy in October and an ultrasound next month so those tests will be updated, however Canadians cannot enter the US or vice versa until Covid restrictions are lifted. I have had PVT for 18 years and am 60 years old now.

      1. Ahmed

        I have a blood disorder that causes my blood to clot more easily than the average person. Best of luck on the tests and I hope the procedure with Dr. Salem will be an available option for you.

        1. Clint Post author

          I also have a clotting disorder that has never been pin-pointed. Over the years I have had extensive testing to determine the cause, but to no avail. Anyways I am glad you are doing well. Take care, and be safe. Clint

  2. Mary Stokes

    Hi Clint– I want to echo Ahmed’s story with my own similar one! After reading this post, I consulted my gastro and hepatologist and ultimately emailed Dr. Salem as well, and sent him a copy of my latest CT scan. He believed that I would be a great candidate for the procedure and before I knew it I was on a road trip to Chicago from Atlanta in the middle of a pandemic.

    My procedure was two days ago and was a success; my platelet count is already climbing back up and my pressure is down. I feel great and I am also looking forward to a regular-ish life without the constant fear of a bleed.

    I can’t tell you how easy Dr. Salem and his team made this for me. They handled all appointments, all insurance contacts, everything. I was just told when to show up and where and then everything was taken care of by an incredible network of doctors, nurses, and technicians. If you are dealing with PVT and can get to Chicago, what are you waiting for?

    1. Clint Post author

      This is seriously good news! Thank you for sharing! I will be sending my work-ups to Dr.Salem also. I am in Canada so don’t know how it will work for me to go down, but I guess it will be figured out as time progresses. I had an Ultrasound yesterday and a CT scan coming up on the 24th. Colonoscopy is scheduled for October. A friend in Minnesita just came back from seeing Dr.Salem this past weekend and I am anxious to speak with him also. Thanks again – so happy to hear of your success!

    2. Lobsang

      Thank you for sharing your success story.please tell me how to connect with dr Saleem.I have mailed several times in the given mail I’d of dr Saleem but still didn’t get any response.I am from India and would like to consult dr Saleem but not able to do so.i would be very thankful if you help me.

    3. Lobsang

      Happy to hear that now you are free from portal vein thrombosis.could you tell me the cost of procedure? I am from India and fighting with PVT disease since 1 year.

    4. Judith sheldon

      I have the same issues as you Mary and w antiphosphlipid syndrome. Wow the fact that our issues Plus extra veins, varices and the dr encouraged this ! And it is a nonsurgical procedure threading with spleen rather than w portal vein Very encouraging. Please keep in touch.

  3. Cathy

    Hi! I’m newly diagnosed non-cirrhotic PVT due to oral contraceptives. I have to this burning sensation in my throat and abdominal pain that moves to my right upper quadrant and my hematologist doesn’t think it’s related to the PVT. May I ask if anyone has this symptoms. I’m just so confused. Please help. Thanks.

    1. Clint Post author

      Hi Cathy,

      Please read the response to your questions, directly from Dr.Salem himself.

      Keep us posted. Wishing you success with your condition!


      1. Cathy

        Thank you so much Clint. Really appreciate sharing this info to all of us. Hope all goes well with you. God bless you.

        1. Charly Barberino

          Hi Cathy,

          I also have a non-cirrhotic PVT associated with my pregnancy discovered In September of last year, and am experiencing extremely similar symptoms to the ones you described above. The burning sensation and moving pain in my chest are there, they went away for a couple of months after I began treatment with enoxaparin, and then returned with varying degrees of severity over the last 3 months or so. My PVT also resulted in a cavernous transformation/calcification. I am curious if you have had any further updates since your last post, either in changes in your symptoms/treatment, or input from Dr. Salem and his team? I am looking for hope and further understanding on how to improve and manage these symptoms as the pain is a daily occurrence. Would really appreciate any feedback you have!

          Thank you!


  4. ron dubetz

    Wow some positive results However as you have said COVID is a barrier as well as costs. I think on a FB post Ken Epp had suggested possibly a Go Fund Page

    I will be in prayer for you



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