Background And Aims: The portal pressure gradient (PPG) measured at the time of transjugular intrahepatic portosystemic shunt (TIPS) completion (immediate PPG) is easily disturbed by many factors. This study aimed to assess the diagnostic value of PPG remeasured 2-4 days after TIPS (delayed PPG) by comparison with immediate PPG.
Methods: We retrospectively analyzed cirrhotic patients aged 18-75 years who received TIPS for preventing variceal rebleeding and pressure measurements at different time points.
Results: Of 154 eligible patients, 60 (39.0%), 62 (40.3%), and 32 (20.8%) were categorized into group LL (both immediate and delayed PPG < 12 mmHg), LH (immediate PPG < but delayed PPG ≥ 12 mmHg) and HH (both immediate and delayed PPG ≥ 12 mmHg), respectively. Mean immediate and delayed PPG were 9.2 mmHg and 12.8 mmHg (p < 0.001). During a median follow-up of 22 months, the 1-year probability of variceal rebleeding was significantly lower in group LL (1.7%) compared to LH (9.8%, absolute risk difference [ARD]: - 8.2%, p = 0.028) and HH (12.6%, ARD: - 11.1%, p = 0.014), but was not significantly different between groups LH and HH (ARD: - 2.9%, p = 0.671). Delayed PPG (p < 0.001) was identified as an independent predictor of variceal rebleeding in multivariable Cox regression analysis. The area under curves of delayed and immediate PPG in predicting variceal rebleeding were 0.837 and 0.693 for all patients (p = 0.031), and 0.936 and 0.694 for patients without shunt dysfunction (p < 0.001).
Conclusions: In cirrhotic patients with variceal bleeding, delayed PPG has higher predictive power for variceal rebleeding than immediate PPG.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s12072-022-10440-6 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Multi-Scale Computational Model of the Hepatic Circulation Applied to Predict the Portal Pressure After Transjugular Intrahepatic Portosystemic Shunt (TIPS).
Int J Numer Method Biomed Eng
January 2025
Hebei Provincial Key Laboratory of Portal Hypertension and Cirrhosis, Xingtai People's Hospital, Xingtai, China; Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
Transjugular intrahepatic portosystemic shunt (TIPS) is a widely used surgery for portal hypertension. In clinical practice, the diameter of the stent forming a shunt is usually selected empirically, which will influence the postoperative portal pressure. Clinical studies found that inappropriate portal pressure after TIPS is responsible for poor prognosis; however, there is no scheme to predict postoperative portal pressure.
View Article and Find Full Text PDFProgressive systemic inflammation precedes decompensation in compensated cirrhosis.
JHEP Rep
February 2025
Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramon y Cajal de Investigación Sanitaria (IRYCIS), Universidad de Alcalá, Madrid, Spain.
Background & Aims: Systemic inflammation is a driver of decompensation in cirrhosis with unclear relevance in the compensated stage. We evaluated inflammation and bacterial translocation markers in compensated cirrhosis and their dynamics in relation to the first decompensation.
Methods: This study is nested within the PREDESCI trial, which investigated non-selective beta-blockers for preventing decompensation in compensated cirrhosis and clinically significant portal hypertension (CSPH: hepatic venous pressure gradient ≥10 mmHg).
Objective: To evaluate the impact of intrahepatic portal vein branching (IHPB)-grade assessment using preoperative CT angiography (CTA) on the surgical procedure and prognosis prediction for dogs with an extrahepatic portosystemic shunt (EHPSS).
Methods: This study involved 146 client-owned dogs with EHPSS. The shunt morphology of EHPSS and IHPB grades was determined using CTA.
Federally qualified health center patients' experiences with remote patient monitoring as part of telehealth services for self-measured blood pressure monitoring.
BMC Health Serv Res
January 2025
Center for Quality Health IT Improvement (CQHII), McWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, USA.
Background: Remote patient monitoring (RPM) for hypertension management has become increasingly popular, demonstrating benefits for both clinics and patients. However, patient engagement in self-measured blood pressure (SMBP) monitoring remains low despite healthcare providers' efforts. This study aimed to assess adherence and acceptance of RPM for SMBP among Texas Federally Qualified Health Center patients.
View Article and Find Full Text PDFPredictive Value of Serum Lactate Levels for Mortality in Patients with Hepatitis B-Related Decompensated Cirrhosis: A Retrospective Analysis.
Br J Hosp Med (Lond)
December 2024
Department of Gastroenterology, The Second People's Hospital of Quzhou, Quzhou, Zhejiang, China.
Decompensated cirrhosis is characterized by the progression of cirrhosis from an asymptomatic state to elevated portal pressure and marked deterioration of liver function. This pathological condition progresses rapidly following onset, significantly raising the risk for mortality. The aim of this study is to explore the association between serum lactate concentrations and mortality rates in individuals with hepatitis B-induced decompensated cirrhosis and to evaluate its potential as a clinical prognostic indicator.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!