ABSTRACT Background symptomatic heart failure developed in 6%. Six‐month and one‐year survival rates were 85% and 76%, respectively, without significant difference between pre‐TIPS compensated and decompensated patients ( p = 0.21). Conclusions U.N‐TIPS represents an applicable strategy for enabling curative oncologic surgery in selected patients with cirrhosis and CSPH. Under‐dilation reduces shunt‐related complications while preserving hemodynamic efficacy, expanding TIPS applicability. Impact and Implications U.N‐TIPS addresses the critical barrier of portal hypertension in oncologic patients with cirrhosis, offering access to surgical treatments considered unfeasible while maintaining an adequate safety profile. These findings are particularly significant for hepatologists, oncologists, interventional radiologists, and surgeons managing the increasingly common clinical scenario of cirrhosis with concurrent extrahepatic malignancies. In clinical practice, our results support the implementation of multidisciplinary tumour boards that incorporate portal pressure assessment and TIPS indication in pre‐surgical planning. However, large, controlled studies are needed to compare outcomes between compensated patients with CSPH who undergo U.N‐TIPS versus those who do not receive this intervention.
Saltini et al. (Tue,) studied this question.