SynthesisBMJ open gastroenterology2024
Efficacy of TIPS plus extrahepatic collateral embolisation in real-world data: a validation study.
Synthesis in BMJ open gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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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.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Gastric varices: a contemporary review of vascular anatomy and therapeutic strategies.BMJ open gastroenterology · 2026Review
- 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
- Impact of quantitative dietary guidance on postoperative outcomes in patients undergoing transjugular intrahepatic portosystemic shunt surgery: a retrospective cohort study.Frontiers in nutrition · 2026Article
- Machine learning-driven risk stratification to guide variceal embolization in TIPS-treated cirrhotic patients with acute variceal bleeding.BMC medical informatics and decision making · 2025Article
- Application of artificial intelligence in portal hypertension and esophagogastric varices.World journal of gastroenterology · 2025Review
Corrections and comments
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Authors and funding
17 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe efficacy of transjugular intrahepatic portosystemic shunt (TIPS) plus extrahepatic collateral embolisation (TIPS+E) in reducing rebleeding and hepatic encephalopathy (HE) post-TIPS was recently reported in a meta-analysis, but further validation is essential. This study aims to confirm the effectiveness of TIPS+E using real-world data.
methodsThe multicentre retrospective cohort included 2077 patients with cirrhosis who underwent TIPS±E (TIPS: 631, TIPS+E: 1446) between January 2010 and December 2022. Regression and propensity score matching (PSM) were used to adjust for baseline characteristic differences. After PSM, clinical outcomes, including rebleeding, HE, survival and further decompensation (FDC), were analysed. Baseline data from all patients contributed to the construction of prognostic models.
resultsAfter PSM, 1136 matched patients (TIPS+E: TIPS=568:568) were included. TIPS+E demonstrated a significant reduction in rebleeding (HR 0.77; 95% CI 0.59 to 0.99; p=0.04), HE (HR 0.82; 95% CI 0.68 to 0.99; p=0.04) and FDC (HR 0.85; 95% CI 0.73 to 0.99; p=0.04), comparing to TIPS. Significantly, TIPS+E also reduced rebleeding, HE and FDC in subgroup of using 8 mm diameter stents and embolising of gastric varices+spontaneous portosystemic shunts (GV+SPSS). However, there were no differences in overall or subgroup survival analysis. Additionally, the random forest models showed higher accuracy and AUROC comparing to other models. Controlling post-TIPS portal pressure gradient (pPPG) within 7 mm Hg<pPPG<8.5 mm Hg improved prognosis, especially in TIPS+E group.
conclusionOur real-world data validation confirms the high efficacy of TIPS+E in reducing rebleeding and HE, particularly when using 8 mm diameter stents, embolising GV+SPSS and maintaining an optimal pPPG.
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