Portal hypertension is the consequence of cirrhosis and results from increased sinusoidal vascular resistance and hepatic blood inflow. Etiological therapies represent the first intervention to prevent a significant increase in portal pressure due to chronic liver damage. However, other superimposed pathophysiological drivers may worsen liver disease, including inflammation, bacterial translocation, endothelial dysfunction, and hyperactivation of hemostasis. These mechanisms can be targeted by a specific class of drugs already used in clinical practice. Albumin, rifaximin, statins, aspirin, and anticoagulants have been tested in cirrhosis and were a topic of discussion in the last Baveno consensus as non-etiological therapies. Based on the pathogenesis of portal hypertension in cirrhosis, our review summarizes the main mechanisms targeted by these drugs as well as the clinical evidence that considers them a valid complementary option to manage patients with cirrhosis and portal hypertension.
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http://dx.doi.org/10.3390/jcm12030934 | DOI Listing |
J Clin Gastroenterol
January 2025
The Third Central Hospital of Tianjin, Hedong District.
Goals: To explore dynamic contrast-enhanced ultrasound (CEUS) parameters in predicting hepatic vein pressure gradient (HVPG) for patients with liver cirrhosis (LC).
Background: Noninvasive diagnosis of HVPG remains a challenge.
Study: This prospective study included patients with LC undergoing hepatic vein catheterization and pressure measurement at the hospital from May 2021 to January 2023.
World J Gastroenterol
January 2025
Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou 510151, Guangdong Province, China.
Background: Transjugular intrahepatic portosystemic shunt (TIPS) is an effective intervention for managing complications of portal hypertension, particularly acute variceal bleeding (AVB). While effective in reducing portal pressure and preventing rebleeding, TIPS is associated with a considerable risk of overt hepatic encephalopathy (OHE), a complication that significantly elevates mortality rates.
Aim: To develop a machine learning (ML) model to predict OHE occurrence post-TIPS in patients with AVB using a 5-year dataset.
J Biomech
January 2025
School of Mechanical Engineering, Hefei University of Technology, Hefei, Anhui 230009, PR China. Electronic address:
Hemodynamic processes from the portal vein(PV) to the inferior vena cava(IVC) were mimicked for three patients with portal hypertension(PH) and the effects of stent parameters on the outcomes of transjugular intrahepatic portosystemic shunt(TIPS) were investigated through computational fluid dynamics(CFD). The liver region was simulated with porous media model and the spatial distributions of superior mesenteric vein(SMV) and splenic vein(SV) blood were solved through the Eulerian multiphase model. The present method is able to simulate the PH flow and predict the PV pressure, the stent shunt rate and the SMV blood proportion after TIPS treatment.
View Article and Find Full Text PDFActa Clin Belg
January 2025
Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium.
Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (POPH) are two distinct pulmonary vascular complications seen in patients with liver disease and/or portal hypertension. HPS is characterized by disturbed gas exchange and hypoxemia because of intrapulmonary vascular dilatations. POPH is defined by pulmonary arterial hypertension, which might lead to right heart failure.
View Article and Find Full Text PDFWorld J Gastrointest Surg
January 2025
Department of Surgery, Gastroenterology and Digestive Endoscopy Unit, ASST Santi Paolo e Carlo, University of Milan, Milan 20142, Lombardy, Italy.
Trans-jugular intrahepatic portosystemic stent shunting (TIPSS) has been in use for many years with great results and many evolutions. The procedure essentially involves the insertion of a metal covert stent to create an Hepato-Hepatic portosystemic shunt. Over time, TIPSS has become the subject of many studies aimed at examining its clinical utility and evaluating the results of using TIPSS to manage complications related to portal hypertension.
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