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Dear Antonio, dear friends,
Happy new year to the VALDIG group.
I agree that revising TIPS, including pressure measurement in the portal trunk, would be very useful. This thrombosis of portal trunk is surprising and desserves investigations.
Anticoagulation will likely be useful to avoid extension of thrombosis, particularly if thrombosis of the portal trunk and of splenic vein are recent.
I would be very cautious with splenectomy given the bad results the VALDIG group reported in Hepatology: PMID: 30924941
I would really favor -as mentioned above- splenic vein recanalization since it would likely be -if feasible- a good option.