Acute propranolol administration effectively decreases portal pressure in patients with TIPS dysfunction
Open Access
- 1 January 2003
- Vol. 52 (1) , 130-133
- https://doi.org/10.1136/gut.52.1.130
Abstract
Background and aims: Up to 60% of patients treated with transjugular intrahepatic portosystemic shunt (TIPS) require angioplasty or restenting during the first year of follow up because of TIPS dysfunction (stenosis of the intrahepatic shunt increasing the portal pressure gradient above the 12 mm Hg threshold). We hypothesised that in patients with TIPS stenosis, propranolol administration, by decreasing portal inflow, would markedly decrease portal pressure. Patients and methods: Eighteen patients with TIPS dysfunction were investigated by measuring portal pressure gradient before and after acute propranolol administration (0.2 mg/kg intravenously; n=18). Results: Propranolol markedly reduced the portal pressure gradient (from 16.6 (3.5) to 11.9 (4.8) mm Hg; pv 1/8; p=0.015). Conclusions: Propranolol therapy may delay the increase in portal pressure and reduce the need for reintervention in patients with TIPS dysfunction.Keywords
This publication has 31 references indexed in Scilit:
- Predictive value of the variceal pressure response to continued pharmacological therapy in patients with cirrhosis and portal hypertensionHepatology, 2000
- Effects of end‐to‐side portacaval shunt and distal splenorenal shunt on systemic and pulmonary haemodynamics in patients with cirrhosisJournal of Gastroenterology and Hepatology, 1999
- Transjugular Intrahepatic Portosystemic ShuntSeminars in Liver Disease, 1999
- Effects of propranolol on the hepatic hemodynamic response to physical exercise in patients with cirrhosisHepatology, 1998
- Circulatory effects of graded diversion of portal blood flow to the systemic circulation in rats: Role of nitric oxideHepatology, 1997
- Haemodynamic adaptation two months after transjugular intrahepatic portosystemic shunt (TIPS) in cirrhotic patients.Gut, 1996
- Partial Versus Total Portacaval Shunt in Alcoholic Cirrhosis Results of a Prospective, Randomized Clinical TrialAnnals of Surgery, 1994
- Propranolol Decreases Portal Pressure Without Changing Portocollateral Resistance in Cirrhotic RatsHepatology, 1989
- Increased Portal Venous Resistance Hinders Portal Pressure Reduction During the Administration of β–Adrenergic Blocking Agents in A Portal Hypertensive ModelHepatology, 1985
- Effects of Propranolol on Azygos Venous Blood Flow and Hepatic and Systemic Hemodynamics in CirrhosisHepatology, 1984