Translational gastroenterology and hepatology · 2026
Predictive target of portal pressure reduction and clinical significance of the portal vein thrombosis subgroup for hepatic encephalopathy after TIPS in decompensated cirrhosis.
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Ran Di, Feng Yuxia, Chen Ya, Yang Jie
Аннотация
BACKGROUND: Portal pressure reduction magnitude (ΔPVP) is a key hemodynamic indicator during transjugular intrahepatic portosystemic shunt (TIPS) procedures, but its relationship with post-TIPS hepatic encephalopathy remains incompletely understood. This study aimed to determine the optimal intraoperative ΔPVP threshold for predicting post-TIPS hepatic encephalopathy.
METHODS: A total of patients who underwent TIPS were retrospectively analyzed. The optimal ΔPVP threshold was identified using receiver operating characteristic curve analysis.
RESULTS: ΔPVP showed a reverse L-shaped association with post-TIPS hepatic encephalopathy, and a ΔPVP threshold of 20 cmH₂O was identified. Patients achieving ΔPVP ≥ 20 cmH₂O had a lower risk of post-TIPS hepatic encephalopathy, particularly in the absence of portal vein thrombosis (PVT).
CONCLUSIONS: Intraoperative ΔPVP ≥ 20 cmH₂O may serve as a clinically useful target for patients without PVT. External multicenter validation is required to confirm these findings.
METHODS: A total of patients who underwent TIPS were retrospectively analyzed. The optimal ΔPVP threshold was identified using receiver operating characteristic curve analysis.
RESULTS: ΔPVP showed a reverse L-shaped association with post-TIPS hepatic encephalopathy, and a ΔPVP threshold of 20 cmH₂O was identified. Patients achieving ΔPVP ≥ 20 cmH₂O had a lower risk of post-TIPS hepatic encephalopathy, particularly in the absence of portal vein thrombosis (PVT).
CONCLUSIONS: Intraoperative ΔPVP ≥ 20 cmH₂O may serve as a clinically useful target for patients without PVT. External multicenter validation is required to confirm these findings.