Timing Affects Measurement of Portal Pressure Gradient After Placement of Transjugular Intrahepatic Portosystemic Shunts in Patients With Portal Hypertension

Background & Aims A reduction in portal pressure gradient (PPG) to Methods We performed a retrospective study of 155 consecutive patients with severe complications of portal hypertension who received placement of TIPS from January 2008 through October 2015; patients were followed until March 2016. We compared PPG values measured at different time points and under different conditions: immediately after placement of TIPS (immediate PPG); at least 24 hours after placement to TIPS into hemodynamically stable patients, without sedation (early PPG); and again 1 month after TIPS placement (late PPG). Results The immediate PPG differed significantly from the early PPG, regardless of whether the TIPS was placed using general anesthesia (8.5 ± 3.5 mm Hg vs 10 ± 3.5 mm Hg; P  = .015) or deep sedation (12 ± 4 mm Hg vs 10.5 ± 4 mm Hg; P P Conclusions In a retrospective study of patients with PPG values measured at different time points after TIPS placement, we found measurements of PPG in awake, hemodynamically stable patients at least 24 hours after TIPS to be the best maintained values. Our findings support the concept that PPG value