Timing Affects Measurement of Portal Pressure Gradient After Placement of Transjugular Intrahepatic Portosystemic Shunts in Patients With Portal Hypertension

Gastroenterology
Gilberto Silva-JuniorJuan Carlos Garcia-Pagan

Abstract

A reduction in portal pressure gradient (PPG) to <12 mm Hg after placement of a transjugular intrahepatic portosystemic shunt (TIPS) correlates with the absence of further bleeding or ascites at follow-up examinations of patients with cirrhosis. The PPG is usually measured immediately after placement of the TIPS, when different circumstances can affect PPG values, which could affect determination of risk for decompensation. We investigated variations in PPG measurements collected at different time points after TIPS, aiming to identify a time point after which PPG values were best maintained. We performed a retrospective study of 155 consecutive patients with severe complications of portal hypertension who received placement of TIPS from January 2008 through October 2015; patients were followed until March 2016. We compared PPG values measured at different time points and under different conditions: immediately after placement of TIPS (immediate PPG); at least 24 hours after placement to TIPS into hemodynamically stable patients, without sedation (early PPG); and again 1 month after TIPS placement (late PPG). The immediate PPG differed significantly from the early PPG, regardless of whether the TIPS was placed using general anes...Continue Reading

References

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Citations

Aug 8, 2018·AJR. American Journal of Roentgenology·Aichi ChienStephen Kee
Oct 18, 2020·Journal of Hepatology·José Ferrusquía-AcostaVirginia Hernández-Gea
Mar 6, 2021·Journal of Hepatology·Jitao WangXiaolong Qi

Related Concepts

General Anesthesia
Blood Pressure Determination
Gastric Varix
Hematochezia
Hypertension, Portal
Relapse
Retrospective Studies
Portal Pressure
Transjugular Intrahepatic Portosystemic Shunt Procedure
Deep Sedation

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