Work

Effect of transjugular intrahepatic portosystemic shunt on platelet count and exact spleen volume segmented on computed tomography

Year: 2025

Type: article

Abstract: Background: Transjugular intrahepatic portosystemic shunt (TIPS) is effective for portal decompression, but its effect on splenic congestion is not proven. Platelet changes and spleen size following TIPS are controversially reported while the exact volume of the spleen has rarely been investigated. Purpose: To analyze the effect of TIPS placement on portosystemic gradient (PSG), platelet count (PLT), and exact spleen volume (SV) using contrast-enhanced computed tomography (CT). Methods: For study inclusion, successful TIPS placements in adult patients with liver cirrhosis and portal hypertension who received CT within 3 months prior and 12 months after TIPS-placement were reviewed (12/2013-09/2021). Exclusion criteria were additional liver/portal interventions, TIPS-dysfunction, progressive portal/liver vein occlusion and hepatic malperfusion or progressive portosystemic collaterals, and active bleeding on CT. Additionally, patients with splenic/hematological disorders, hemodialysis, and clinical apparent infections/multi-organ-failure/death were excluded. PSG and PLT were recorded. Exact SV were segmented on pre-/post-TIPS-CT. Data were compared before and after TIPS placement. Mean ± standard deviation and significance level (p) were given. Results: = .160). Conclusion: When exact SV is assessed and confounders are excluded using CT, neither a significant SV reduction nor a PLT-increase are detected following TIPS. Patients without PLT increase and SV reduction after TIPS might benefit from additional interventions (e.g., splenic artery embolization).

Source: Acta Radiologica Open

DOI: 10.1177/20584601251391994

Authors: Seben Sena Yerdelen, Benjamin Maasoumy, Jan B. Hinrichs, Bernhard Chr. Meyer, Frank K. Wacker, Timo C. Meine

Institutions: Medizinische Hochschule Hannover, St. Bernward Krankenhaus

Language: English

Topic: Liver Disease and Transplantation

Subfield: Hepatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,023