Transjugular intrahepatic portosystemic shunt (TIPS) is created to reduce portal pressure. The target post-TIPS portosystemic gradient is:
- A <6 mmHg
- B <20 mmHg
- C <12 mmHg ✓
- D <25 mmHg
Correct answer: C. <12 mmHg
Explanation
The clinical target for TIPS is a portosystemic gradient (PSG) <12 mmHg, as variceal bleeding risk drops significantly below this threshold. A PSG <5 mmHg may cause hepatic encephalopathy due to excessive shunting. The pre-TIPS PSG in portal hypertension is typically >12 mmHg; the goal is to halve it to <12 mmHg. HVPG <10 mmHg (below the clinical significant portal hypertension threshold) is the ideal target where possible.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
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