Related Experiment Video
Updated: May 2, 2026
09:37
Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
Published on: August 1, 2018
15.5K
Determining the optimal portal pressure gradient after small-diameter TIPS for ascites: a retrospective study
Guofeng Liu1, Songchi Xiao1, Xiaoze Wang1
1Department of Gastroenterology and Hepatology, Sichuan University-University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Therapeutic Advances in Gastroenterology
|September 15, 2025
Summary
A portal pressure gradient (PPG) of 8-10 mmHg after transjugular intrahepatic portosystemic shunt (TIPS) placement is optimal for managing ascites. This range effectively controls ascites and decompensation risks without increasing hepatic encephalopathy.
Area of Science:
- Hepatology
- Interventional Radiology
- Clinical Outcomes Research
Background:
- The optimal portal pressure gradient (PPG) threshold post-transjugular intrahepatic portosystemic shunt (TIPS) for ascites management is not well-defined.
- Small-diameter (8-mm) TIPS are increasingly used for refractory or recurrent ascites.
Purpose of the Study:
- To determine the relationship between post-TIPS PPG and clinical outcomes in patients undergoing 8-mm TIPS for ascites.
- To identify an optimal PPG range for effective ascites control and reduced complications.
Main Methods:
- Retrospective analysis of 143 patients receiving 8-mm TIPS for ascites from June 2015 to June 2023.
- Evaluation of ascites response, overt hepatic encephalopathy (OHE), decompensation, and mortality using Fine and Gray competing risk regression.
- Receiver operating characteristic (ROC) curve analysis to identify PPG prediction cutoffs.
Main Results:
- Post-TIPS PPG reliably predicted ascites response (cutoff 10.5 mmHg) and OHE (cutoff 7.5 mmHg).
- A PPG range of 8-10 mmHg was associated with lower ascites incidence (HR=5.74), reduced OHE risk (HR=2.87), and decreased decompensation risk (HR=2.78).
- PPG >10 mmHg increased ascites and decompensation risk, while PPG <8 mmHg increased OHE risk.
Conclusions:
- Post-TIPS PPG is a significant predictor of clinical outcomes in patients with ascites undergoing 8-mm TIPS.
- An optimal post-TIPS PPG range of 8-10 mmHg balances ascites control with risks of encephalopathy and decompensation.
- This finding supports targeted hemodynamic management following TIPS placement for ascites.
