{"title":"Noninvasive subharmonic-aided pressure estimation for surgical management of portal hypertension: a clinical study in TIPS patients.","authors":"Ziyin Zhu, Si Liang, Linxue Qian","doi":"10.23736/S2724-5691.25.10917-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Portal hypertension (PH) is a critical condition often managed through surgical interventions such as transjugular intrahepatic portosystemic shunt (TIPS). Conventional portal pressure monitoring relies on invasive measurements, necessitating alternative approaches. Subharmonic-aided pressure estimation (SHAPE) technology offers a noninvasive method utilizing contrast-enhanced ultrasound, potentially reducing procedural risks. This study evaluated the clinical utility of SHAPE in assessing portal hypertension and monitoring hemodynamic changes pre- and post-TIPS placement.</p><p><strong>Methods: </strong>A total of 23 patients with PH underwent direct portal vein pressure (PVP) measurement, and SHAPE was performed for noninvasive estimation. Six patients who underwent TIPS received SHAPE evaluations before and after the procedure. Agreement and correlation between SHAPE and PVP were analyzed.</p><p><strong>Results: </strong>SHAPE demonstrated a strong correlation with PVP (P<0.001), with significant changes observed post-TIPS (P=0.011). These findings suggest SHAPE as a valuable tool for noninvasive monitoring of PH and evaluating TIPS efficacy.</p><p><strong>Conclusions: </strong>SHAPE technology presents a promising noninvasive alternative for assessing portal hypertension in surgical settings. It offers a safer and efficient approach to monitoring hemodynamic changes, particularly in patients undergoing TIPS, potentially reducing reliance on invasive procedures.</p>","PeriodicalId":29847,"journal":{"name":"Minerva Surgery","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Minerva Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.23736/S2724-5691.25.10917-9","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
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Abstract
Background: Portal hypertension (PH) is a critical condition often managed through surgical interventions such as transjugular intrahepatic portosystemic shunt (TIPS). Conventional portal pressure monitoring relies on invasive measurements, necessitating alternative approaches. Subharmonic-aided pressure estimation (SHAPE) technology offers a noninvasive method utilizing contrast-enhanced ultrasound, potentially reducing procedural risks. This study evaluated the clinical utility of SHAPE in assessing portal hypertension and monitoring hemodynamic changes pre- and post-TIPS placement.
Methods: A total of 23 patients with PH underwent direct portal vein pressure (PVP) measurement, and SHAPE was performed for noninvasive estimation. Six patients who underwent TIPS received SHAPE evaluations before and after the procedure. Agreement and correlation between SHAPE and PVP were analyzed.
Results: SHAPE demonstrated a strong correlation with PVP (P<0.001), with significant changes observed post-TIPS (P=0.011). These findings suggest SHAPE as a valuable tool for noninvasive monitoring of PH and evaluating TIPS efficacy.
Conclusions: SHAPE technology presents a promising noninvasive alternative for assessing portal hypertension in surgical settings. It offers a safer and efficient approach to monitoring hemodynamic changes, particularly in patients undergoing TIPS, potentially reducing reliance on invasive procedures.
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