{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T23:34:48Z","timestamp":1772753688724,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,7,18]],"date-time":"2019-07-18T00:00:00Z","timestamp":1563408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81873917"],"award-info":[{"award-number":["81873917"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>This study aims to evaluate and compare the survival and other portal hypertension\u2010related complications of patients with portal pressure gradient (PPG)\u00a0\u2265\u00a025\u00a0mmHg using transjugular intrahepatic portosystemic shunt (TIPS) as the first\u2010line and second\u2010line therapies in secondary prophylaxis of variceal hemorrhage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty patients diagnosed with liver cirrhosis were enrolled in this retrospective study, with 35 of whom received TIPS as the first\u2010line therapy in secondary prophylaxis of variceal hemorrhage and 15 of whom as second\u2010line treatment. We observed and analyzed the survival, occurrence of variceal rebleeding and hepatic encephalopathy (HE) of patients in the two groups during the follow up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The technical success rate was 100%. In a median follow\u2010up time of 12 (1\u201337) and 15 (2\u201327) months, respectively, significant statistical difference was observed between the first\u2010line group and the second\u2010line group concerning cumulative survival rate (94.3% <jats:italic>vs<\/jats:italic> 66.7%, log\u2013rank <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01). But that was not the case when it comes to the cumulative rate of variceal rebleeding (8.6% <jats:italic>vs<\/jats:italic> 26.7%, log\u2013rank <jats:italic>P<\/jats:italic>\u00a0=\u00a00.164) and HE (22.9% <jats:italic>vs<\/jats:italic> 20.0%, log\u2013rank <jats:italic>P<\/jats:italic>\u00a0=\u00a00.793). And multivariate analysis indicated that group assignment (hazard ratio\u00a0=\u00a08.250, 95% confidence interval\u00a0=\u00a01.383\u201349.213, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.021) was the only predictor of survival. Interestingly, we found that spleen diameter (hazard ratio\u00a0=\u00a00.578, 95% confidence interval\u00a0=\u00a00.393\u20130.849, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.005) could be regarded as independent predictor of the occurrence of HE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For patients with PPG\u00a0\u2265\u00a025\u00a0mmHg who have recovered from an episode of acute esophageal variceal hemorrhage, utilizing TIPS as the first\u2010line therapy to prevent rebleeding is demonstrated effective in improving the survival and therefore should be recommended to a wider range of clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14761","type":"journal-article","created":{"date-parts":[[2019,6,21]],"date-time":"2019-06-21T05:05:37Z","timestamp":1561093537000},"page":"278-283","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Using transjugular intrahepatic 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