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reported that although 74% of patients engaged in some form of exercise and 64% received educational support, only 19% adhered to all first-line guideline-consistent treatments, highlighting implementation gaps in clinical settings (Mazzei et al., 2022)

Therefore, a bypassing key, i.e., an activated azygos vein as a rescuing pathway, avoiding both the lung and liver and also noted in BuddChiari syndrome (i.e., suprahepatic occlusion of the inferior caval vein) (Gojkovic et al., 2020), combines the inferior caval vein and superior caval vein via direct blood delivery

Comment: In addition to general support, commenters offered several specific suggestions and considerations

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