Pre-emptive TIPS with 8-mm stents reduces hepatic encephalopathy without compromising efficacy in acute variceal bleeding.

ABSTRACT:

Background & aims

Pre-emptive transjugular intrahepatic portosystemic shunt (TIPS) improves outcomes in high-risk acute variceal bleeding but its use is limited by hepatic encephalopathy (HE). While stent diameter and post-TIPS portacaval pressure gradient (PPG) targets may influence HE risk, evidence-based standards are lacking. This study aimed to compare 8-mm vs. 10-mm diameter stents and evaluate PPG thresholds to balance HE risk and therapeutic efficacy.

Methods

In this multicenter observational study, 470 patients with cirrhosis and acute variceal bleeding receiving pre-emptive TIPS (8-mm: n = 384; 10-mm: n = 86) were analyzed. Competing risks regression and restricted cubic splines were used to assess associations between stent diameter, PPG, and clinical outco

SUBMITTER: Lv Y 

PROVIDER: S-EPMC12557597 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature