ArticleHepatology international2023
Individualized portal pressure gradient threshold based on liver function categories in preventing rebleeding after TIPS.
Article in Hepatology international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 13 citations in OpenAlex.
- Baseline Portal Vein Thrombosis does not Worsen Long-Term Outcomes After Technically Successful TIPS in Cirrhotic Variceal Bleeding: A Single-Center Retrospective Cohort Study.Cardiovascular and interventional radiology · 2026Article
- Coaxial stent TIPS with 5 to 8 mm controlled expansion improving overall prognosis in cirrhotic patients: a prospective cohort study with target trial emulation.Hepatology international · 2026Article
- [Research advances on hepatic encephalopathy following transjugular intrahepatic portosystemic shunt].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Review
- Effect of portal pressure gradient reduction on outcomes after transjugular intrahepatic portosystemic shunt in portal hypertension patients.World journal of hepatology · 2025Article
- Optimal threshold of portal pressure gradient for patients with ascites after covered TIPS: a multicentre cohort study.Hepatology international · 2025Article
- Hepatic encephalopathy post-TIPS: Current status and prospects in predictive assessment.Computational and structural biotechnology journal · 2024Review
- Post-Transjugular Intrahepatic Portosystemic Shunt (TIPS) Hepatic Encephalopathy-A Review of the Past Decade's Literature Focusing on Incidence, Risk Factors, and Prophylaxis.Journal of clinical medicine · 2023Review
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Authors and funding
17 authors at 11 institutions in 1 country.
Funding
Abstract
backgroundThe evidence in Portal pressure gradient (PPG) < 12 mmHg after transjugular intrahepatic portosystemic shunt (TIPS) for preventing rebleeding mostly comes from observations in uncovered stents era. Moreover, association between Child-Pugh classes and post-TIPS hepatic encephalopathy (HE) has indicated that tolerance of PPG reduction depends on liver function. This study aimed to investigate the optimal PPG for covered TIPS and explore the optimal threshold tailored to the Child-Pugh classes to find individualized PPG to balance rebleeding and overt HE.
methodsThis multicenter retrospective study analyzed rebleeding, OHE, and mortality of patients associated with post-TIPS PPGs (8, 10, 12, and 14 mmHg) in the entire cohort and among different Child-Pugh classes. Propensity score matching (PSM) and competing risk analyses were performed for sensitivity analyses.
resultsWe included 2100 consecutively screened patients undergoing TIPS. In all patients, PPG < 12 mmHg reduced rebleeding after TIPS (p = 0.022). In Child-Pugh class A, none of the PPG thresholds were discriminative of clinical outcomes. In Child-Pugh class B, 12 mmHg (p = 0.022) and 14 mmHg (p = 0.037) discriminated rebleeding, but 12 mmHg showed a higher net benefit. In Child-Pugh class C, PPG < 14 mmHg had a lower rebleeding incidence (p = 0.017), and exhibited more net benefit than 12 mmHg.
conclusionDifferent PPG standards may be required for patients with different liver function categories. A PPG threshold < 12 mmHg might be suitable for patients in Child-Pugh class B, while < 14 mmHg might be optimal for patients in Child-Pugh class C.
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