ArticleActa radiologica open2025
Effect of transjugular intrahepatic portosystemic shunt on platelet count and exact spleen volume segmented on computed tomography.
Article in Acta radiologica open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Background: Transjugular intrahepatic portosystemic shunt (TIPS) is effective for portal decompression, but its effect on splenic congestion is not proven. Platelet changes and spleen size following TIPS are controversially reported while the exact volume of the spleen has rarely been investigated. Purpose: To analyze the effect of TIPS placement on portosystemic gradient (PSG), platelet count (PLT), and exact spleen volume (SV) using contrast-enhanced computed tomography (CT). Methods: For study inclusion, successful TIPS placements in adult patients with liver cirrhosis and portal hypertension who received CT within 3 months prior and 12 months after TIPS-placement were reviewed (12/2013-09/2021). Exclusion criteria were additional liver/portal interventions, TIPS-dysfunction, progressive portal/liver vein occlusion and hepatic malperfusion or progressive portosystemic collaterals, and active bleeding on CT. Additionally, patients with splenic/hematological disorders, hemodialysis, and clinical apparent infections/multi-organ-failure/death were excluded. PSG and PLT were recorded. Exact SV were segmented on pre-/post-TIPS-CT. Data were compared before and after TIPS placement. Mean ± standard deviation and significance level (p) were given. Results: Overall, data of 18 TIPS procedures were available for comparison. PSG reduction following TIPS placement was significant (pre: 18 ± 7 mmHg, post: 5 ± 2 mmHg; Conclusion: When exact SV is assessed and confounders are excluded using CT, neither a significant SV reduction nor a PLT-increase are detected following TIPS. Patients without PLT increase and SV reduction after TIPS might benefit from additional interventions (e.g., splenic artery embolization).
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