In TIPS (Transjugular Intrahepatic Portosystemic Shunt) placement for variceal bleeding, which measurement guides the adequacy of shunt function?
- A Portosystemic pressure gradient (target <12 mmHg or reduction by ≥20%) ✓
- B Portal vein diameter on ultrasound
- C Child-Pugh score improvement after the procedure
- D Serum albumin level post-procedure
Correct answer: A. Portosystemic pressure gradient (target <12 mmHg or reduction by ≥20%)
Explanation
The technical success of TIPS is assessed by measurement of the portosystemic gradient (PSG = portal pressure minus right atrial pressure). The target is to reduce PSG to <12 mmHg or by ≥20% from baseline, which correlates with elimination of varices and prevention of rebleeding. A PSG >12 mmHg is the threshold above which variceal haemorrhage risk is significantly elevated. Shunt stenosis is monitored with Doppler ultrasound. Post-TIPS hepatic encephalopathy is a major complication related to diversion of portal blood.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.