Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/18654
Title: Acute propranolol administration effectively decreases portal pressure in patients with TIPS dysfunction. Transjugular intrahepatic portosystemic shunt.
Author: Bellis, L.
Moitinho, E.
Abraldes, Juan G.
Graupera i Garcia-Milà, Mariona
García Pagán, Juan Carlos
Rodés, J.
Bosch i Genover, Jaume
Keywords: Hipertensió portal
Beta-blocadors
Pressió venosa
Portal hypertension
Adrenergic beta blockers
Venous pressure
Issue Date: 2003
Publisher: BMJ Group
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; p<0.0001), cardiac index (−26 (7)%), and heart rate (−18 (7)%) (p<0.0001). Portal pressure gradient decreased to less than 12 mm Hg in nine patients, more frequently in those with moderate dysfunction (portal pressure gradient 16 mm Hg) than in patients with severe dysfunction (portal pressure gradient >16 mm Hg) (8/10 v 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.
Note: Reproducció digital del document publicat a: http://dx.doi.org/10.1136/gut.52.1.130
It is part of: Gut, 2003, vol. 52, núm. 1, p. 130-133
Related resource: http://dx.doi.org/10.1136/gut.52.1.130
URI: http://hdl.handle.net/2445/18654
ISSN: 0017-5749
Appears in Collections:Articles publicats en revistes (Medicina)

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