{ "schemaVersion": 2, "eyebrow": "Hepatology", "title": "Portal Hypertension", "summary": "Use portal-pressure thresholds and noninvasive risk stratification to identify clinically significant portal hypertension, prevent first decompensation, and select endoscopic or shunt-based therapy for bleeding and refractory ascites.", "seoDescription": "Portal hypertension: clinically significant thresholds, elastography and platelet criteria, variceal prevention, and TIPS selection in cirrhosis.", "clinicalQuestion": "How should physicians stratify, prevent, and treat clinically significant portal hypertension and its major complications?", "specialty": "Gastroenterology and Hepatology", "audience": "U.S. physicians and medical trainees", "tags": [ "portal hypertension", "clinically significant portal hypertension", "HVPG", "transient elastography", "esophageal varices", "carvedilol", "TIPS", "refractory ascites" ], "keyTakeaways": [ "An HVPG of at least 10 mmHg defines clinically significant portal hypertension (CSPH), the pressure range associated with varices and decompensation. [6][9][14]", "In compensated advanced chronic liver disease, liver stiffness measurement below 15 kPa plus platelets above 150 × 10^9/L rules out CSPH; liver stiffness measurement of at least 25 kPa confirms CSPH. [16]", "Use a nonselective beta-blocker to prevent decompensation in CSPH; reserve endoscopic variceal ligation for compensated patients with high-risk esophageal varices who cannot take a nonselective beta-blocker. [12]", "Consider TIPS for refractory ascites and secondary prophylaxis of esophageal variceal hemorrhage, while balancing benefit against hepatic encephalopathy and cardiopulmonary risk. [11][23][24]" ], "sections": [ { "id": "triage-and-pressure-phenotype", "eyebrow": "Risk definition", "heading": "Identify the portal-pressure phenotype that changes management", "intro": "Separate compensated risk stratification from active portal-hypertensive complications.", "paragraphs": [ "Hepatic venous pressure gradient (HVPG) is the difference between wedged and free hepatic venous pressures and remains the reference standard for portal-pressure measurement. Portal hypertension is conventionally defined by HVPG at least 5 mmHg; CSPH is defined by HVPG at least 10 mmHg and is associated with development of varices and clinical decompensation. [6][14]", "Use HVPG selectively when a direct hemodynamic measurement will resolve an important management question. Interpret a normal or low HVPG cautiously when presinusoidal disease is suspected, because wedged hepatic venous pressure measurement does not detect presinusoidal portal hypertension, including portal-vein obstruction. [14]", "Treat ascites, variceal hemorrhage, and hepatic encephalopathy as decompensating events rather than as isolated findings; compensated versus decompensated status is a major prognostic and therapeutic branch. [15] Acute gastrointestinal bleeding requires immediate hemodynamic assessment and source-directed endoscopic management rather than outpatient noninvasive risk stratification." ], "bullets": [], "subsections": [], "table": { "caption": "Portal-pressure assessment thresholds and their clinical interpretation. [6][14][16]", "columns": [ "Finding", "Interpretation", "Next clinical use" ], "rows": [ [ "HVPG ≥5 mmHg", "Portal hypertension. [6][14]", "Establishes hemodynamic portal hypertension when directly measured. [6][14]" ], [ "HVPG ≥10 mmHg", "CSPH; associated with varices and decompensation. [6][9][14]", "Initiate prevention strategy for decompensation when clinically appropriate. [12]" ], [ "LSM <15 kPa and platelets >150 × 10^9/L", "Rules out CSPH in the Baveno VII noninvasive framework. [16]", "Avoid labeling the patient as having CSPH on the basis of compensated advanced chronic liver disease alone. [16]" ], [ "LSM ≥25 kPa", "Confirms CSPH in the Baveno VII noninvasive framework. [16]", "Assess candidacy for nonselective beta-blocker therapy and portal-hypertension surveillance. [12][16]" ] ] } }, { "id": "noninvasive-stratification", "eyebrow": "Compensated disease", "heading": "Use elastography and platelets to triage compensated advanced chronic liver disease", "intro": "Apply noninvasive criteria before reflexively ordering endoscopy or invasive pressure measurement.", "paragraphs": [ "Obtain vibration-controlled transient elastography liver stiffness measurement (LSM) and platelet count in compensated advanced chronic liver disease. LSM below 15 kPa with platelets above 150 × 10^9/L rules out CSPH, whereas LSM at least 25 kPa confirms CSPH. [16] Patients between these boundaries require individualized risk assessment rather than binary classification from either test alone.", "LSM reflects cumulative stiffness from fibrosis and portal hypertension in cirrhosis and correlates with HVPG; however, values may vary materially between transient-elastography systems and agreement decreases with higher body mass index. Follow patients with the same validated platform when serial LSM will influence management. [7][15]", "Spleen stiffness may add information when LSM is indeterminate. A spleen stiffness threshold of at least 21 kPa has been used to screen for CSPH, but this threshold should not replace the better-established LSM/platelet rule-out and rule-in criteria. [8][16]" ], "bullets": [ "Do not use HVPG alone to exclude portal hypertension when portal-vein obstruction or another presinusoidal process is plausible. [14]", "If LSM is below 20 kPa and platelets exceed 150 × 10^9/L, prior Baveno criteria did not recommend screening endoscopy; reconcile this with current CSPH-directed management and the individual indication for variceal assessment. [15][16]" ], "subsections": [], "table": null }, { "id": "prevent-first-decompensation", "eyebrow": "Primary prevention", "heading": "Select nonselective beta-blockade or ligation for high-risk varices", "intro": "The preventive goal in CSPH is prevention of first decompensation, not only prevention of first bleeding.", "paragraphs": [ "For compensated cirrhosis with CSPH, use a nonselective beta-blocker (NSBB) to prevent decompensation. Current consensus cited in the clinical literature places NSBBs first-line for this objective. [12] Carvedilol, propranolol, and nadolol reduce portal pressure, but agent selection must account for bradycardia, hypotension, fatigue, respiratory adverse effects, and the potential to worsen refractory ascites, hepatorenal syndrome, or hepatic encephalopathy. [23]", "For a compensated patient with high-risk esophageal varices who has a contraindication to or intolerance of NSBB therapy, perform endoscopic variceal ligation (EVL). EVL is an alternative in this setting rather than a routine add-on to tolerated NSBB therapy for primary prevention. [12]", "Reassess the risk-benefit balance of NSBB therapy when circulatory intolerance, refractory ascites, hepatorenal syndrome, or recurrent encephalopathy develops. The relevant tradeoff is portal-pressure reduction versus adverse cardiovascular effects and potential deterioration in vulnerable decompensated patients. [23]" ], "bullets": [ "Use NSBB therapy first for compensated CSPH when tolerated. [12]", "Use EVL for high-risk esophageal varices when NSBB therapy is contraindicated or not tolerated. [12]", "Monitor for bradycardia, hypotension, respiratory symptoms, fatigue, and clinical worsening of ascites, hepatorenal syndrome, or encephalopathy after NSBB initiation or adjustment. [23]" ], "subsections": [], "table": null }, { "id": "ascites-and-shunt-selection", "eyebrow": "Decompensated disease", "heading": "Escalate refractory ascites and recurrent variceal bleeding to TIPS assessment", "intro": "TIPS offers portal decompression when medical and endoscopic approaches no longer provide adequate control.", "paragraphs": [ "For refractory ascites, large-volume paracentesis with human albumin is a first-line strategy cited by Baveno guidance; some patients require procedures every 2 weeks, while others require intervals of 4 to 6 weeks. Consider TIPS as an elective alternative or escalation strategy, recognizing that some patients will still require paracentesis after TIPS. [11]", "TIPS is a minimally invasive radiologic portosystemic shunt that directly decompresses portal pressure. Established major indications include treatment of refractory ascites and secondary prophylaxis of esophageal variceal hemorrhage; additional uses include selected early treatment of esophageal variceal hemorrhage, Budd-Chiari syndrome, ectopic varices, and portal-vein thrombosis. [24]", "Before TIPS referral, evaluate whether expected decompression benefit outweighs the risk of hepatic encephalopathy and adverse outcomes in patients with cardiopulmonary or hepatic vulnerability. TIPS reduces variceal rebleeding and can control refractory ascites, but encephalopathy is a key tradeoff; NSBBs instead carry hemodynamic and respiratory tolerability constraints. [23][24]" ], "bullets": [], "subsections": [], "table": { "caption": "Portal-decompression options for selected complications. [11][23][24]", "columns": [ "Clinical problem", "Preferred escalation", "Principal tradeoff" ], "rows": [ [ "Refractory ascites", "Large-volume paracentesis plus human albumin; consider elective TIPS. [11][24]", "TIPS may improve ascites control but carries hepatic encephalopathy risk. [23]" ], [ "Recurrent esophageal variceal hemorrhage", "TIPS for secondary prophylaxis in appropriate candidates. [24]", "Balance portal decompression against encephalopathy and patient-specific contraindications. [23][24]" ], [ "Varices inaccessible to endoscopic therapy", "Consider portal decompression with TIPS. [24]", "Requires procedural candidacy assessment and post-shunt monitoring. [24]" ] ] } }, { "id": "noncirrhotic-portal-vein-thrombosis", "eyebrow": "Etiologic branch", "heading": "Recognize noncirrhotic portal-vein thrombosis as a recurrent-thrombosis phenotype", "intro": "Do not apply cirrhosis-based assumptions without confirming the underlying vascular disorder.", "paragraphs": [ "In noncirrhotic portal-vein thrombosis, long-term complications include gastrointestinal bleeding related to portal hypertension and recurrent thrombosis. [2] Confirm the vascular anatomy and distinguish this phenotype from cirrhotic portal hypertension because HVPG may not detect presinusoidal portal hypertension due to portal-vein obstruction. [14]", "Rivaroxaban prophylaxis has been studied to reduce venous thromboembolism and portal-hypertension-related bleeding outcomes in noncirrhotic portal-vein thrombosis. [2][3] Treatment selection should incorporate the competing risks of recurrent thrombosis and portal-hypertensive gastrointestinal bleeding rather than extrapolating directly from cirrhosis algorithms. [2]" ], "bullets": [], "subsections": [], "table": null } ], "faq": [], "references": [ { "number": 1, "title": "Supplementary appendix", "detail": "www.thelancet.com", "url": "https://www.thelancet.com/cms/10.1016/S0140-6736(18)31875-0/attachment/a3a3c80c-fc15-4df8-8022-6d2730112473/mmc1.pdf", "authors": "www.thelancet.com", "host": "www.thelancet.com" }, { "number": 2, "title": "Rivaroxaban Prophylaxis in Noncirrhotic Portal Vein Thrombosis", "detail": "evidence.nejm.org", "url": "https://evidence.nejm.org/doi/full/10.1056/EVIDoa2200104", "authors": "evidence.nejm.org", "host": "evidence.nejm.org" }, { "number": 3, "title": "Rivaroxaban Prophylaxis in Noncirrhotic Portal Vein ...", "detail": "evidence.nejm.org", "url": "https://evidence.nejm.org/doi/pdf/10.1056/EVIDoa2200104", "authors": "evidence.nejm.org", "host": "evidence.nejm.org" }, { "number": 4, "title": "Esophageal Varices: Development Secondary to Primary ...", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/583190", "authors": "jamanetwork.com", "host": "jamanetwork.com" }, { "number": 5, "title": "The Evolution of Portal Hypertension Surgery", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jamasurgery/fullarticle/390775", "authors": "jamanetwork.com", "host": "jamanetwork.com" }, { "number": 6, "title": "Noninvasive Assessment of Portal Hypertension in Chronic Liver Disease | Gastroenterology and Hepatology | Clinical Sciences | Health sciences | Topics | Nature Index", "detail": "www.nature.com", "url": "https://www.nature.com/nature-index/topics/l4/noninvasive-assessment-of-portal-hypertension-in-chronic-liver-disease", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 7, "title": "Comparison of two transient elastography (TE) systems for measuring liver stiffness in clinical practice | Scientific Reports", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-025-06151-1", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 8, "title": "Clinically significant portal hypertension assessed by ...", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-025-23635-2", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 9, "title": "The impact of esophagogastric varices on the prognosis ...", "detail": "www.nature.com", "url": "https://www.nature.com/articles/srep42577", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 10, "title": "Comparison with the Portal Hypertension of Cirrhosis and ...", "detail": "www.acpjournals.org", "url": "https://www.acpjournals.org/doi/10.7326/0003-4819-66-1-41", "authors": "www.acpjournals.org", "host": "www.acpjournals.org" }, { "number": 11, "title": "Cirrhosis in over 16s: assessment and management (update)", "detail": "www.nice.org.uk", "url": "https://www.nice.org.uk/guidance/ng50/update/ng50-update-1/documents/evidence-review-3", "authors": "www.nice.org.uk", "host": "www.nice.org.uk" }, { "number": 12, "title": "Study Details | NCT06594783 | Carvedilol Plus EVL or Not for the Primary Prevention of Esophageal Variceal Bleeding in Carvedilol Non-responders | ClinicalTrials.gov", "detail": "clinicaltrials.gov", "url": "https://clinicaltrials.gov/study/NCT06594783", "authors": "clinicaltrials.gov", "host": "clinicaltrials.gov" }, { "number": 13, "title": "套扎术对比空白对照用于肝硬化和食管静脉曲张的成人上 ...", "detail": "www.cochranelibrary.com", "url": "https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012673.pub2/full/zh_HANS", "authors": "www.cochranelibrary.com", "host": "www.cochranelibrary.com" }, { "number": 14, "title": "Clinical Study of the BreathID MCS System to train the algorithm ...", "detail": "cdn.clinicaltrials.gov", "url": "https://cdn.clinicaltrials.gov/large-docs/78/NCT02143778/Prot_SAP_000.pdf", "authors": "cdn.clinicaltrials.gov", "host": "cdn.clinicaltrials.gov" }, { "number": 15, "title": "Gawrieh et al. August 5, 2021 - 1 - Non-invasive Evaluation of ...", "detail": "cdn.clinicaltrials.gov", "url": "https://cdn.clinicaltrials.gov/large-docs/97/NCT04576897/Prot_000.pdf", "authors": "cdn.clinicaltrials.gov", "host": "cdn.clinicaltrials.gov" }, { "number": 16, "title": "Assessing the safety of discontinuing non-selective beta- ...", "detail": "cdn.clinicaltrials.gov", "url": "https://cdn.clinicaltrials.gov/large-docs/73/NCT06549673/Prot_SAP_000.pdf", "authors": "cdn.clinicaltrials.gov", "host": "cdn.clinicaltrials.gov" }, { "number": 17, "title": "Study Details | NCT06523608 | Prediction of Decompensation and HCC Development in Advanced Chronic Liver Disease | ClinicalTrials.gov", "detail": "clinicaltrials.gov", "url": "https://clinicaltrials.gov/study/NCT06523608", "authors": "clinicaltrials.gov", "host": "clinicaltrials.gov" }, { "number": 18, "title": "Study Details | NCT04975477 | CHESS-SAVE Score to Stratify Decompensation Risk in Compensated Advanced Chronic Liver Disease (CHESS2102) | ClinicalTrials.gov", "detail": "clinicaltrials.gov", "url": "https://clinicaltrials.gov/study/NCT04975477", "authors": "clinicaltrials.gov", "host": "clinicaltrials.gov" }, { "number": 19, "title": "Abdominal ultrasound and alpha‐fetoprotein for the ...", "detail": "www.cochranelibrary.com", "url": "https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013346/references", "authors": "www.cochranelibrary.com", "host": "www.cochranelibrary.com" }, { "number": 20, "title": "Study Details | NCT03267615 | VICIS - Vienna Cirrhosis Study | ClinicalTrials.gov", "detail": "clinicaltrials.gov", "url": "https://clinicaltrials.gov/study/NCT03267615", "authors": "clinicaltrials.gov", "host": "clinicaltrials.gov" }, { "number": 21, "title": "Band ligation versus beta‐blockers for primary prophylaxis ...", "detail": "www.cochranelibrary.com", "url": "https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010546.pub2/full", "authors": "www.cochranelibrary.com", "host": "www.cochranelibrary.com" }, { "number": 22, "title": "Platelet count, spleen length, and ...", "detail": "www.cochranelibrary.com", "url": "https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008759.pub2/full", "authors": "www.cochranelibrary.com", "host": "www.cochranelibrary.com" }, { "number": 23, "title": "Transjugular intrahepatic portosystemic shunt and non-selective beta-blockers act as friends or foe in decompensated cirrhosis: A comparative review - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12019065", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov" }, { "number": 24, "title": "Transjugular Intrahepatic Portosystemic Shunt: Indications, Contraindications, and Patient Work-Up - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4139433", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov" } ], "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.", "citations": [ { "number": 1, "title": "Supplementary appendix", "detail": "www.thelancet.com", "url": "https://www.thelancet.com/cms/10.1016/S0140-6736(18)31875-0/attachment/a3a3c80c-fc15-4df8-8022-6d2730112473/mmc1.pdf", "authors": "www.thelancet.com", "host": "www.thelancet.com", "snippet": "Portal pressure was measured as the hepatic venous pressure ... HVPG, hepatic venous pressure gradient. CO, cardiac output. MAP", "score": 0.37552378 }, { "number": 2, "title": "Rivaroxaban Prophylaxis in Noncirrhotic Portal Vein Thrombosis", "detail": "evidence.nejm.org", "url": "https://evidence.nejm.org/doi/full/10.1056/EVIDoa2200104", "authors": "evidence.nejm.org", "host": "evidence.nejm.org", "snippet": "by A Plessier · 2022 · Cited by 67 — The two major complications of long-term PVT are gastrointestinal bleeding related to portal hypertension and recurrent thrombosis.", "score": 0.27982405 }, { "number": 3, "title": "Rivaroxaban Prophylaxis in Noncirrhotic Portal Vein ...", "detail": "evidence.nejm.org", "url": "https://evidence.nejm.org/doi/pdf/10.1056/EVIDoa2200104", "authors": "evidence.nejm.org", "host": "evidence.nejm.org", "snippet": "by A Plessier · 2022 · Cited by 67 — We assessed the effects of rivaroxaban on the risk of venous thromboembolism and portal hypertension-related bleeding in such patients.", "score": 0.20046411 }, { "number": 4, "title": "Esophageal Varices: Development Secondary to Primary ...", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/583190", "authors": "jamanetwork.com", "host": "jamanetwork.com", "snippet": "by RC Kurtz · 1974 · Cited by 28 — A retrospective analysis over a 20-year period at Memorial Sloan-Kettering Cancer Center disclosed 17 cases of portal hypertension and esophageal varices.", "score": 0.10963924 }, { "number": 5, "title": "The Evolution of Portal Hypertension Surgery", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jamasurgery/fullarticle/390775", "authors": "jamanetwork.com", "host": "jamanetwork.com", "snippet": "by H Orozco · 2000 · Cited by 96 — Hypothesis Surgery for portal hypertension has evolved widely in the past decades. Selection criteria and the type of operations have evolved because of the", "score": 0.10625414 }, { "number": 6, "title": "Noninvasive Assessment of Portal Hypertension in Chronic Liver Disease | Gastroenterology and Hepatology | Clinical Sciences | Health sciences | Topics | Nature Index", "detail": "www.nature.com", "url": "https://www.nature.com/nature-index/topics/l4/noninvasive-assessment-of-portal-hypertension-in-chronic-liver-disease", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "### Technical terms\n\nPortal hypertension: Elevated pressure within the portal venous system, often defined by an HVPG ≥5 mmHg and clinically significant when ≥10 mmHg.\n\nHepatic venous pressure gradient (HVPG): The difference between wedged and free hepatic vein pressures; gold standard for measuring", "score": 0.7732339 }, { "number": 7, "title": "Comparison of two transient elastography (TE) systems for measuring liver stiffness in clinical practice | Scientific Reports", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-025-06151-1", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "(r = 0.219, p = 0.009) and a negative correlation with AST (r=-0.217, p = 0.01) and GGT (r=-0.170, p = 0.044). In the same population LSM-D was negatively associated with portal vein caliber (r=-0.189, p = 0.04) and with long spleen axis (r=-0.287, p = 0.001). For patients with LSMFibroscan < 5 kPa ", "score": 0.57437146 }, { "number": 8, "title": "Clinically significant portal hypertension assessed by ...", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-025-23635-2", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "by W Nasomsong · 2025 — SSM ≥ 21 kPa was used as a threshold to screen for clinically significant portal hypertension. Screening for high-risk esophageal varices was", "score": 0.54535896 }, { "number": 9, "title": "The impact of esophagogastric varices on the prognosis ...", "detail": "www.nature.com", "url": "https://www.nature.com/articles/srep42577", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "by WY Hsieh · 2017 · Cited by 46 — an HVPG greater than 10 mmHg has been designated as clinically significant portal hypertension (CSPH)16. Elastography, spleen size, and", "score": 0.43482184 }, { "number": 10, "title": "Comparison with the Portal Hypertension of Cirrhosis and ...", "detail": "www.acpjournals.org", "url": "https://www.acpjournals.org/doi/10.7326/0003-4819-66-1-41", "authors": "www.acpjournals.org", "host": "www.acpjournals.org", "snippet": "the portal hypertension in each patient is associated with good liver function and structure and patent portal and splenic veins.", "score": 0.3280777 }, { "number": 11, "title": "Cirrhosis in over 16s: assessment and management (update)", "detail": "www.nice.org.uk", "url": "https://www.nice.org.uk/guidance/ng50/update/ng50-update-1/documents/evidence-review-3", "authors": "www.nice.org.uk", "host": "www.nice.org.uk", "snippet": "clinical guidelines: Baveno (2022) recommends that LVP in combination with human albumin as the 1st line treatment, while NICE recommends that TIPSS is considered. The cost of each treatment strategy is derived from the Mattock (2021) cost effectiveness study. LVP plus human albumin occurring every ", "score": 0.61279696 }, { "number": 12, "title": "Study Details | NCT06594783 | Carvedilol Plus EVL or Not for the Primary Prevention of Esophageal Variceal Bleeding in Carvedilol Non-responders | ClinicalTrials.gov", "detail": "clinicaltrials.gov", "url": "https://clinicaltrials.gov/study/NCT06594783", "authors": "clinicaltrials.gov", "host": "clinicaltrials.gov", "snippet": "Kaplan DE, Ripoll C, Thiele M, Fortune BE, Simonetto DA, Garcia-Tsao G, Bosch J. AASLD Practice Guidance on risk stratification and management of portal hypertension and varices in cirrhosis. Hepatology. 2024 May 1;79(5):1180-1211. doi: 10.1097/HEP.0000000000000647. Epub 2023 Oct 23. No abstract ava", "score": 0.6102915 }, { "number": 13, "title": "套扎术对比空白对照用于肝硬化和食管静脉曲张的成人上 ...", "detail": "www.cochranelibrary.com", "url": "https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012673.pub2/full/zh_HANS", "authors": "www.cochranelibrary.com", "host": "www.cochranelibrary.com", "snippet": "Guidelines have been formulated for the management of portal hypertension in a series of 'Baveno' consensus workshops undertaken at intervals", "score": 0.5440511 }, { "number": 14, "title": "Clinical Study of the BreathID MCS System to train the algorithm ...", "detail": "cdn.clinicaltrials.gov", "url": "https://cdn.clinicaltrials.gov/large-docs/78/NCT02143778/Prot_SAP_000.pdf", "authors": "cdn.clinicaltrials.gov", "host": "cdn.clinicaltrials.gov", "snippet": "method does not detect presinusoidal portal hypertension, e.g. due to portal vein obstruction). HVPG > 5 mm Hg defines PHT, whereas HVPG ≥ 10mm Hg is recognized as “clinically significant portal hypertension (CSPH)”, as it is the pressure threshold that predicts many of the complications of cirrhosi", "score": 0.54274267 }, { "number": 15, "title": "Gawrieh et al. August 5, 2021 - 1 - Non-invasive Evaluation of ...", "detail": "cdn.clinicaltrials.gov", "url": "https://cdn.clinicaltrials.gov/large-docs/97/NCT04576897/Prot_000.pdf", "authors": "cdn.clinicaltrials.gov", "host": "cdn.clinicaltrials.gov", "snippet": "helpful for both clinical practice and research purposes. Cirrhosis should no longer be regarded as a terminal disease and the concept of a dynamic process is increasingly accepted. A prognostic clinical subclassification with four distinct stages has been proposed with substantially differing likeli", "score": 0.4635177 }, { "number": 16, "title": "Assessing the safety of discontinuing non-selective beta- ...", "detail": "cdn.clinicaltrials.gov", "url": "https://cdn.clinicaltrials.gov/large-docs/73/NCT06549673/Prot_SAP_000.pdf", "authors": "cdn.clinicaltrials.gov", "host": "cdn.clinicaltrials.gov", "snippet": "Stop-NSBB V1.0 dated 4 Dec 2023 1 Assessing the safety of discontinuing non-selective beta-blockers in cirrhotic patients with managed primary aetiological factors according to Baveno VII consensus (Short title: Stop-NSBB Study) Clinical study protocol Prepared by: Vincent Wong Professor Department ", "score": 0.43036336 }, { "number": 17, "title": "Study Details | NCT06523608 | Prediction of Decompensation and HCC Development in Advanced Chronic Liver Disease | ClinicalTrials.gov", "detail": "clinicaltrials.gov", "url": "https://clinicaltrials.gov/study/NCT06523608", "authors": "clinicaltrials.gov", "host": "clinicaltrials.gov", "snippet": "de Franchis R; Baveno V Faculty. Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension. J Hepatol. 2010 Oct;53(4):762-8. doi: 10.1016/j.jhep.2010.06.004. Epub 2010 Jun 27. No abstract available.:762-8. doi:", "score": 0.4224814 }, { "number": 18, "title": "Study Details | NCT04975477 | CHESS-SAVE Score to Stratify Decompensation Risk in Compensated Advanced Chronic Liver Disease (CHESS2102) | ClinicalTrials.gov", "detail": "clinicaltrials.gov", "url": "https://clinicaltrials.gov/study/NCT04975477", "authors": "clinicaltrials.gov", "host": "clinicaltrials.gov", "snippet": "Qi X, Berzigotti A, Cardenas A, Sarin SK. Emerging non-invasive approaches for diagnosis and monitoring of portal hypertension. Lancet Gastroenterol Hepatol. 2018 Oct;3(10):708-719. doi: 10.1016/S2468-1253(18)30232-2.:708-719. doi: 10.1016/S2468-1253(18)30232-2. (opens in a new tab)\")(\n de Franchi", "score": 0.40867847 }, { "number": 19, "title": "Abdominal ultrasound and alpha‐fetoprotein for the ...", "detail": "www.cochranelibrary.com", "url": "https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013346/references", "authors": "www.cochranelibrary.com", "host": "www.cochranelibrary.com", "snippet": "Expanding consensus in portal hypertension. Report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension.", "score": 0.32572478 }, { "number": 20, "title": "Study Details | NCT03267615 | VICIS - Vienna Cirrhosis Study | ClinicalTrials.gov", "detail": "clinicaltrials.gov", "url": "https://clinicaltrials.gov/study/NCT03267615", "authors": "clinicaltrials.gov", "host": "clinicaltrials.gov", "snippet": "Hofer BS, Simbrunner B, Hartl L, Jachs M, Balcar L, Paternostro R, Schwabl P, Semmler G, Scheiner B, Trauner M, Mandorfer M, Reiberger T. Hepatic recompensation according to Baveno VII criteria is linked to a significant survival benefit in decompensated alcohol-related cirrhosis. Liver Int. 2023 Oc", "score": 0.24772386 }, { "number": 21, "title": "Band ligation versus beta‐blockers for primary prophylaxis ...", "detail": "www.cochranelibrary.com", "url": "https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010546.pub2/full", "authors": "www.cochranelibrary.com", "host": "www.cochranelibrary.com", "snippet": "by JC Gana · 2019 · Cited by 20 — Portal hypertension is the initial and main consequence of advanced liver disease or cirrhosis and often gives rise to life‐threatening", "score": 0.22456558 }, { "number": 22, "title": "Platelet count, spleen length, and ...", "detail": "www.cochranelibrary.com", "url": "https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008759.pub2/full", "authors": "www.cochranelibrary.com", "host": "www.cochranelibrary.com", "snippet": "Portal hypertension commonly accompanies advanced liver disease and often gives rise to life‐threatening complications, including haemorrhage", "score": 0.19590192 }, { "number": 23, "title": "Transjugular intrahepatic portosystemic shunt and non-selective beta-blockers act as friends or foe in decompensated cirrhosis: A comparative review - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12019065", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "The management of portal hypertension and its complications, such as variceal bleeding, in patients with cirrhosis often involves the use of nonselective beta-blockers (NSBBs) and a transjugular intrahepatic portosystemic shunt (TIPS). Both treatment modalities have demonstrated efficacy; however, e", "score": 0.8033131 }, { "number": 24, "title": "Transjugular Intrahepatic Portosystemic Shunt: Indications, Contraindications, and Patient Work-Up - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4139433", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "The transjugular intrahepatic portosystemic shunt (TIPS) procedure is effective in achieving portal decompression and in managing some of the major complications of portal hypertension. While many clinicians are familiar with the two most common indications for TIPS placement, secondary prophylaxis ", "score": 0.78473216 } ], "publishedAt": "2026-08-24T16:28:16.635346+00:00", "updatedAt": "2026-08-24T16:28:16.635346+00:00", "readingMinutes": 4, "slug": "portal-hypertension" }