Vascular interventions provide a less invasive, safer, and more reliable treatment for portal hypertension, covering the principles of portal bypass, local flow dissection, and flow restriction. Interventional shunts, known as transjugular intrahepatic portosystemic shunts (TIPS), create artificial shunts between the hepatic and portal veins within the hepatic parenchyma, and combine interventional puncture, lumpectomy, and stenting techniques. In the past, the two main complications of TIPS were shunt restenosis and hepatic encephalopathy, which had brought this technique to a low point. With advances in shunt stent construction and materials, and the deeper integration of vascular interventions with gastroenterology in the treatment of cirrhosis, TIPS has seen a second spring in its development. The new overmolded stents isolate the shunt blood flow from the liver tissue, preventing bile from leaking into the shunt or liver tissue from overgrowing into the shunt. The overmolded stent significantly reduced the rate of shunt stenosis after TIPS from 57.6% to 11.6% compared to the bare stent. Supplemented with appropriate postoperative anticoagulation, the stent patency rate was approximately 70% at 3 years after TIPS in several hospitals in China. With the selection of appropriate shunts, the incidence of hepatic encephalopathy after TIPS was also significantly reduced, occurring more often within six months, with an incidence of about 16%, and the incidence was significantly and positively correlated with the preoperative liver function level. The majority of patients have benign hepatic encephalopathy, which is easily recovered after appropriate rehydration and anti-infection treatment. comprehensive medical treatment after TIPS is very important for the long-term outcome of TIPS, and the current treatment concept has progressed from simply emphasizing the “a while” of surgery to the postoperative maintenance of “a lifetime “In China, TIPS treatment teams in Chengdu, Xi’an, Chongqing and Yunnan have set up long-term follow-up mechanisms, which have significantly improved the survival time and quality of patients with cirrhosis after TIPS. TIPS was once positioned as a transitional treatment before liver transplantation. With the full integration of medical therapy and TIPS technology, most patients with Child C liver function have been saved from the death line and their liver function has improved with meticulous medical therapy, reducing the need for liver transplantation. As a flow dissection procedure, gastric coronary vein embolization is mostly performed at the same time as TIPS procedure, and the embolic material is delivered into the gastric coronary vein through the portal system to block the varices more effectively and safely than endoscopic injection of sclerosing agents, etc. In some patients, dissection can also be accomplished by percutaneous hepatic puncture route, etc. Partial splenic artery embolization acts as a flow limiting agent for overall portal hypertension. It is currently used mainly in patients with PH combined with hypersplenism and avoids postoperative splenic and portal vein thrombosis and damage to liver function compared to conventional procedures. After splenic artery embolization, not only the phagocytosis and destruction of blood cells by splenomegaly is weakened, but also the effective splenic parenchyma is reduced, which reduces the blood flow into the portal vein, decreases the portal pressure and reduces the chance of bleeding. Depending on the patient’s specific situation, the three different management modalities of interventional shunt, flow disconnection or flow restriction can be performed individually or applied in two or three combinations of the three options.