ArticleTherapeutic advances in gastroenterology2025
Determining the optimal portal pressure gradient after small-diameter TIPS for ascites: a retrospective study.
Article in Therapeutic advances in gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Urostomy-associated stomal variceal hemorrhage secondary to portal hypertension: A case report and interventional radiology-guided management.Radiology case reports · 2026Article
- Predictive target of portal pressure reduction and clinical significance of the portal vein thrombosis subgroup for hepatic encephalopathy after TIPS in decompensated cirrhosis.Translational gastroenterology and hepatology · 2026Article
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Authors and funding
7 authors.
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Abstract
Background: The optimal hemodynamic threshold for portal pressure gradient (PPG) following transjugular intrahepatic portosystemic shunt (TIPS) for ascites remains uncertain. Objective: This study aimed to elucidate the relationship between post-TIPS PPG and clinical outcomes in patients undergoing small-diameter (8-mm) TIPS for ascites. Design: Single-center retrospective study. Methods: From June 2015 to June 2023, consecutive patients receiving small-diameter (8-mm) TIPS for refractory or recurrent ascites were considered for inclusion retrospectively. The impact of PPG on clinical outcomes-including ascites response, overt hepatic encephalopathy (OHE), further decompensation, and mortality-was evaluated using Fine and Gray competing risk regression models, both unadjusted and adjusted for potential confounders. Results: A total of 143 patients were included in the analysis, of whom 65.7% had refractory ascites, with a median Child-Pugh score of 9. Receiver operating characteristic (ROC) curve analysis identified post-TIPS PPG as a reliable predictor of ascites response (cutoff: 10.5 mmHg, area under curves (AUC): 0.733, Conclusion: This study revealed that post-TIPS PPG was associated with clinical outcomes in patients with refractory or recurrent ascites undergoing small-diameter TIPS. A post-TIPS PPG of 8-10 mmHg seems to be the optimal range, effectively controlling ascites without significantly increasing the risk of shunt-related hepatic encephalopathy, while also reducing the risk of further decompensation.
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