INTRODUCTION: Endovascular therapy represents a less invasive alternative to 
open surgery for reconstruction of the portal vein (PV) and the 
spleno-mesenteric venous confluence to treat Portal hypertension. The objective 
of this study is to determine if the Model for End-Stage Liver Disease (MELD) 
score is a useful method to evaluate the risk of morbidity and mortality during 
endovascular approaches.
MATERIAL AND METHODS: Patients that underwent endovascular reconstruction of the 
PV or spleno-mesenteric confluence were identified retrospectively. Data were 
collected from November 2011 to August 2016. The MELD score was calculated using 
international normalized ratio, serum billirubin and creatinine. Patients were 
grouped into moderate (≤ 15) and high (> 15) MELD. Associations of the MELD 
score on the postprocedural morbidity, mortality and vessels patency were 
assessed by two-sided Fisher's exact test.
RESULTS: Seventeen patients were identified; MELD score distribution was: ≤ 15 
in 10 patients (59%) and > 15 in 7 (41%). Even distribution of severe PV 
thrombosis was treated in both groups, performing predominately jugular access 
in the high MELD score group (OR 0.10; 95%; CI 0.014-0.89; p = 0.052) in 
contrast to a percutaneous transhepatic access in the moderate MELD score group. 
Analysis comparing moderate and high MELD scores was not able to demonstrate 
differences in mortality, morbidity or patency rates.
CONCLUSION: MELD score did not prove to be a useful method to evaluate risk of 
morbidity and mortality; however a high score should not contraindicate 
endovascular approaches. In our experience a high technical success, good 
patency rates and low complication rates were observed.