We previously reported a new and combined EUS-guided intervention in a patient with portal hypertension, consisting of obliteration of varices and partial splenic embolization (PSE). Performing PSE is known to diminish the increase in portal venous pressure after endoscopic intervention for varices. The aim of this study was to use multidetector computer tomography portal venography (MDCTPV) to evaluate the anatomy of esophagogastric varices (EGV) and the impact on hemodynamics of portosystemic collaterals shortly after the concomitant procedures.From October 2019 to December 2020, 5 patients with cirrhosis and with clinically significant portal hypertension who had variceal bleeding history and hypersplenism were treated with combined endoscopic obliteration for varices and EUS-guided PSE. MDCTPV was applied to assess the anatomical drainage patterns of the esophagogastric varices, the diameters of feeders and drainage vessels, and splenic embolization rate, respectively.Within 5 days after concomitant endoscopic interventions, we observed the decrease of mean diameters for left gastric vein (LGV), short gastric vein (SGV), and azygos vein (AZV) as 0.3 mm, 1.0 mm, and 5.2 mm compared with 3.11 mm, 7.1 mm, and 5.4 mm before the procedures. Patients showed increase for both white blood cells (mean count, 2.7X109/L before vs 5.8X109/L after), and platelet counts (mean count, 52.8X109/L before vs 95.8X109/L after). The mean splenic embolization rate was 64.5% (range 28.8% to 84.6%).Our experience may illustrate an alternative technique of combining EUS-guided PSE with endoscopic therapy of varices to treat patients with portal hypertension.Copyright © 2021 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.