Trial reportHepatology (Baltimore, Md.)2023
Targeted decrease of portal hepatic pressure gradient improves ascites control after TIPS.
Trial report in Hepatology (Baltimore, Md.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03628807 (Non-invasive Evaluation of Prognostic Parameters for Patients With Transjugular Intrahepatic Portosystemic Shunt), which is not on this map. Cited by 14 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Non-invasive Evaluation of Prognostic Parameters for Patients With Transjugular Intrahepatic Portosystemic Shunt (TIPS) Using a Structured Follow up Protocol
Who cites it
14 citing papers in PubMed, 31 citations in OpenAlex.
- Shunt magnitude is a key determinant of overt hepatic encephalopathy in patients undergoing TIPS.JHEP reports : innovation in hepatology · 2026Article
- Acute kidney injury after TIPS in decompensated cirrhosis patients: a retrospective cohort study.BMC nephrology · 2025Article
- Transjugular Intrahepatic Portosystemic Shunt for Portal Vein Thrombosis in Cirrhotic Patients: 18-Year Experience in a Tertiary Referral Hospital.Diagnostics (Basel, Switzerland) · 2025Article
- [Position paper for the standardized use of transjugular intrahepatic portosystemic shunt (TIPS) in adults].Zeitschrift fur Gastroenterologie · 2025Article
- Hepatosplenic Volumes and Portal Pressure Gradient Identify One-year Further Decompensation Risk Post-transjugular Intrahepatic Portosystemic Shunt.Journal of clinical and translational hepatology · 2025Article
- Minimal residual ascites 3 months after TIPS implantation implicates worse clinical outcomes in patients with cirrhosis.JHEP reports : innovation in hepatology · 2025Article
- Recompensation of Liver Cirrhosis by TIPS Reduces Epithelial Cell Death Markers, Translating Into Improved Clinical Outcome.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Which patients benefit the most? An update on transjugular intrahepatic portosystemic shunt.World journal of hepatology · 2025Review
- Optimal threshold of portal pressure gradient for patients with ascites after covered TIPS: a multicentre cohort study.Hepatology international · 2025Article
- Determining the optimal portal pressure gradient after small-diameter TIPS for ascites: a retrospective study.Therapeutic advances in gastroenterology · 2025Article
- Bayesian network-based survival prediction model for patients having undergone post-transjugular intrahepatic portosystemic shunt for portal hypertension.World journal of gastroenterology · 2024Article
- Transjugular Intrahepatic Portosystemic Shunt: Devices Evolution, Technical Tips and Future Perspectives.Journal of clinical medicine · 2023Review
- Article
- [Expert consensus on transjugular intrahepatic portosystemic shunt for the treatment of portal hypertension].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2022Article
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Authors and funding
15 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAscites is a definitive sign of decompensated liver cirrhosis driven by portal hypertension. Although transjugular intrahepatic portosystemic shunt insertion (TIPS) is indicated for therapy of recurrent and refractory ascites, there is no evidence-based recommendation for a specific target of portal hepatic pressure gradient (PPG) decrease.
methodsIn this single-center, retrospective trial, we investigated the decrease of PPG in 341 patients undergoing TIPS insertion for therapy of refractory or recurrent ascites until 2015. During each procedure, portal and inferior vena cava pressures were invasively measured and correlated with patients' outcome and ascites progression over time, according to the prespecified Noninvasive Evaluation Program for TIPS and Follow-Up Network protocol (NCT03628807).
resultsPatients without ascites at 6 weeks after TIPS had significantly greater PPG reduction immediately after TIPS, compared to the patients with refractory ascites (median reduction 65% vs. 55% of pre-TIPS PPG; p = 0.001). Survival was significantly better if ascites was controlled, compared to patients with need for paracentesis 6 weeks after TIPS (median survival: 185 vs. 41 weeks; HR 2.0 [1.3-2.9]; p < 0.001). Therefore, higher PPG reduction by TIPS ( p = 0.005) and lower PPG after TIPS ( p = 0.02) correlated with resolution of severe ascites 6 weeks after TIPS. Multivariable analyses demonstrated that higher Child-Pugh score before TIPS (OR 1.3 [1.0-1.7]; p = 0.03) and lower serum sodium levels (OR 0.9 [0.9-1.0]; p = 0.004) were independently associated with ascites persistence 6 weeks after TIPS, whereas PPG reduction (OR 0.98 [0.97-1.00]; p = 0.02) was associated with resolution of ascites 6 weeks after TIPS.
conclusionExtent of PPG reduction and/or lowering of target PPG immediately after TIPS placement is associated with improved ascites control in the short term and with survival in the long term. A structured follow-up visit for patients should assess persistence of ascites at 6 weeks after TIPS.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.