Evidence map›Paper›PMID 36892638›Full record

ArticleJournal of gastroenterology2023

Comparing the predictive ability of portoatrial and portocaval gradient after transjugular intrahepatic portosystemic shunt creation for variceal rebleeding.

Li Ma, Yaozu Liu, Zhiping Yan, Wen Zhang, Zihan Zhang, Minjie Yang, Jiaze Yu, Xin Zhou, Shiyao Chen, Jian Wang and 2 more

Abstract read
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In one paragraph

Article in Journal of gastroenterology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Li Ma *Shanghai Institution of Medical Imaging, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, China.
Yaozu Liu *Shanghai Institution of Medical Imaging, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, China.
Zhiping YanShanghai Institution of Medical Imaging, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, China.
Wen ZhangShanghai Institution of Medical Imaging, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, China.
Zihan ZhangShanghai Institution of Medical Imaging, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, China.
Minjie YangShanghai Institution of Medical Imaging, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, China.
Jiaze YuShanghai Institution of Medical Imaging, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, China.
Xin ZhouDepartment of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Shiyao ChenDepartment of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, China.
Jian WangDepartment of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, China.
Jingqin MaShanghai Institution of Medical Imaging, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, China. ma.jingqin@zs-hospital.sh.cn.
Jianjun LuoShanghai Institution of Medical Imaging, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, China. luo.jianjun@zs-hospital.sh.cn.ORCID http://orcid.org/0000-0003-4942-0439

Funding

Clinical research special fund from Zhongshan Hospital, Fudan University 2018ZSLC23Device development exploration project from National Clinical Research Center for Interventional Medicine 2021-001Excellent youth program from Zhongshan Hospital, Fudan University 2019ZSYXQN38National Key Clinical Specialty Discipline Construction Program of China W2019028
6 · The paper itself

Abstract

backgroundMeasuring the portal pressure gradient from the portal vein (PV) to the inferior vena cava (IVC) or to the right atrium (RA) remains controversial. The aim of our study was to compare the predictive ability of portoatrial gradient (PAG) and portocaval gradient (PCG) for variceal rebleeding.

methodsThe data of 285 cirrhotic patients with variceal bleeding undergoing elective transjugular intrahepatic portosystemic shunt (TIPS) in our hospital were analyzed retrospectively. The variceal rebleeding rates were compared between groups categorized by established or modified thresholds. The median follow-up time was 30.0 months.

resultsAfter TIPS, PAG was equal to (n = 115) or more than (n = 170) PCG. The pressure of IVC was defined as an independent predictor for a PAG-PCG difference of ≥ 2 mmHg (p < 0.001, OR 1.23, 95% CI 1.10-1.37). Using a threshold of 12 mmHg, PAG (p = 0.081, HR 0.63, 95% CI 0.37-1.06) could not predict variceal rebleeding but PCG could (p = 0.003, HR 0.45, 95% CI 0.26-0.77). This pattern was unchanged when a ≥ 50% reduction from baseline was also considered as a threshold (PAG/PCG: p = 0.114 and 0.001). Subgroup analyses showed that only in patients with post-TIPS IVC pressure < 9 mmHg (p = 0.018), PAG could predict variceal rebleeding. Because PAG was on average 1.4 mmHg higher than PCG, patients were classified by a PAG of 14 mmHg, and there was no difference in rebleeding rates between these two groups (p = 0.574).

conclusionsFor patients with variceal bleeding, the predictive ability of PAG is limited. The portal pressure gradient should be measured between the PV and IVC.

Indexed as

Esophageal and Gastric VaricesPortasystemic Shunt, Transjugular IntrahepaticGastrointestinal HemorrhageHumansLiver CirrhosisPortal VeinRetrospective StudiesTreatment OutcomePortal hypertensionPressure gradientVariceal bleeding

Identifiers

PMID36892638

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Registered trials

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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.