ArticleCardiovascular and interventional radiology2022
Transjugular Portosystemic Stent Shunt: Impact of Right Atrial Pressure on Portal Venous Hemodynamics Within the First Week.
Article in Cardiovascular and interventional radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 11 citations in OpenAlex.
- Determinants of Early Renal Function Recovery After TIPS in Patients With Portal Hypertension.The Kaohsiung journal of medical sciences · 2026Article
- TIPS in Older Adults: Reserve-Based Risk Stratification and Practical Approach.Journal of clinical medicine · 2026Review
- Adding Estimates of Central Venous Pressure Boosts the Performance of Non-Invasive Assessment of the Portosystemic Gradient Prior to TIPS Implantation.Diagnostics (Basel, Switzerland) · 2026Article
- Transjugular intrahepatic portosystemic shunt with ePTFE-covered stentgrafts: incidence and predictors of shunt dysfunction.Insights into imaging · 2025Article
- Unveiling the impact of cirrhotic cardiomyopathy on portal hemodynamics and survival after transjugular intrahepatic portosystemic shunt: a prospective study.Abdominal radiology (New York) · 2024Article
- Article
- Comparing the predictive ability of portoatrial and portocaval gradient after transjugular intrahepatic portosystemic shunt creation for variceal rebleeding.Journal of gastroenterology · 2023Article
- Predictive power of portal pressure gradient remeasured shortly after transjugular intrahepatic portosystemic shunt.Hepatology international · 2023Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePorto-systemic pressure gradient is used to prognosticate rebleeding and resolution of ascites after TIPS. This study investigates the reliability of portal pressure characteristics as quantified immediately after TIPS placement and at short-term control. PATIENTS AND
methodsPortal venous pressure (PVP) and right atrial pressure (RAP) were prospectively obtained before and after TIPS as well as ≥ 48 h after TIPS procedure. Porto-systemic pressure gradients (PSG) and pressure changes were calculated. A multivariate regression analysis was performed to predict portal hemodynamics at short-term control.
resultsThe study included 124 consecutive patients. Indications for TIPS were refractory ascites, variceal bleeding or combinations of both. Pre- and post-interventional PSG yielded 16.4 ± 5.3 mmHg and 5.9 ± 2.7 mmHg, respectively. At that time, 105/124 patients (84.7%) met the target (PSG ≤ 8 mmHg). After 4 days (median), PSG was 8.5 ± 3.5 mmHg and only 66 patients (53%) met that target. In patients exceeding the target PSG at follow-up, PVP was significantly higher and RAP was lower resulting in the increased PSG. The highly variable changes of RAP were the main contributor to different pressure gradients. In the multivariate regression analysis, PVP and RAP immediately after TIPS were predictors for PSG at short-term control with moderately predictive capacity (AUC = 0.75).
conclusionBesides the reduction of portal vein pressure, the highly variable right atrial pressure was the main contributor to different pressure gradients. Thus, immediate post-TIPS measurements do not reliably predict portal hemodynamics during follow-up. These findings need to be further investigated with respect to the corresponding clinical course of the patients.
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