2023
AASLD Practice Guidance on risk stratification and management of portal hypertension and varices in cirrhosis
Kaplan D, Ripoll C, Thiele M, Fortune B, Simonetto D, Garcia-Tsao G, Bosch J. AASLD Practice Guidance on risk stratification and management of portal hypertension and varices in cirrhosis. Hepatology 2023, 79: 1180-1211. PMID: 37870298, DOI: 10.1097/hep.0000000000000647.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus Statements
2018
Esophageal Varices
Jakab S, Garcia-Tsao G. Esophageal Varices. 2018, 195-208. DOI: 10.1007/978-3-319-98506-0_15.Peer-Reviewed Educational MaterialsVariceal hemorrhageEsophageal varicesComplications of cirrhosisEsophageal variceal hemorrhageScreening/surveillanceSecondary prophylaxisVariceal bleedingLiver diseaseTreatment optionsCurrent recommendationsHigh riskCirrhosisPrevention strategiesVaricesComplicationsHemorrhagePatientsProphylaxisBleedingMortalityDiseaseEVHProgressionSeverityCirrhosis and Portal Hypertension: Staging and Prognosis
Garcia-Tsao G. Cirrhosis and Portal Hypertension: Staging and Prognosis. 2018, 1-13. DOI: 10.1007/978-3-319-72628-1_1.Peer-Reviewed Educational MaterialsSignificant portal hypertensionPortal hypertensionDecompensated stagePredominant pathophysiological mechanismPresence of varicesGastroesophageal varicesPrognostic significanceReversible diseasePathophysiological mechanismsDifferent therapiesHypertensionVaricesCirrhosisDecompensationPatientsTherapyDisease
2017
Management of Portal Hypertension
Garcia‐Tsao G, Abraldes J. Management of Portal Hypertension. 2017, 304-335. DOI: 10.1002/9781119251316.ch12.Peer-Reviewed Educational MaterialsComplications of cirrhosisPortal hypertensionVariceal hemorrhagePortal pressure gradientInferior vena cavaObjective of treatmentGastroesophageal varicesPortal pressurePathological increaseVena cavaPortal veinCommon causeCirrhosisHypertensionComplicationsHemorrhageMost studiesVaricesDecompensationCavaPrimary and secondary prophylaxis of esophageal variceal bleeding
Jangouk P, Garcia-Tsao G. Primary and secondary prophylaxis of esophageal variceal bleeding. Techniques And Innovations In Gastrointestinal Endoscopy 2017, 19: 84-89. DOI: 10.1016/j.tgie.2017.03.004.Peer-Reviewed Educational MaterialsHepatic venous pressure gradientPortal hypertensionVariceal hemorrhageHigh riskComplications of cirrhosisSignificant portal hypertensionVenous pressure gradientDevelopment of varicesEsophageal variceal bleedingIsolated complicationSecondary prophylaxisCompensated cirrhosisDirect complicationsVariceal bleedingClinical decompensationPortal pressureEsophageal varicesCompensated stageChronic conditionsCirrhosisVaricesComplicationsHemorrhageDecompensationPatientsValidating, deconstructing and refining Baveno criteria for ruling out high‐risk varices in patients with compensated cirrhosis
Jangouk P, Turco L, De Oliveira A, Schepis F, Villa E, Garcia‐Tsao G. Validating, deconstructing and refining Baveno criteria for ruling out high‐risk varices in patients with compensated cirrhosis. Liver International 2017, 37: 1177-1183. PMID: 28160373, PMCID: PMC5511584, DOI: 10.1111/liv.13379.Peer-Reviewed Original ResearchConceptsHigh-risk varicesNegative predictive valueBaveno VI criteriaLiver stiffnessBaveno criteriaPredictive valueItalian cohortPlatelet countNon-invasive criteriaCohort of patientsNumber of endoscopiesUnnecessary endoscopiesCompensated cirrhosisPrimary prophylaxisRetrospective studyUS cohortVariceal screeningTransient elastographyVaricesHigh riskLow prevalenceCirrhosisPatientsEndoscopyClinical diagnosis
2016
Introduction and Survey Results
Garcia-Tsao G, Ripoll C, Augustin S, Reiberger T, Albillos A, Moreau R, Salerno F, Abraldes J. Introduction and Survey Results. 2016, 303-309. DOI: 10.1007/978-3-319-23018-4_30.Peer-Reviewed Original ResearchComplications of cirrhosisRecurrent variceal hemorrhageVariceal hemorrhageDifferent prognostic stagesEndpoints of trialsPresence of varicesInvestigation of patientsCompensated patientsCurrent therapiesSpecific therapyDifferent prognosisPrognostic stageHemorrhageCirrhosisPatientsComplicationsTherapyDifferent efficacyVaricesDecompensationPrognosisRecurrence
2015
Natural History of Cirrhosis
Garcia-Tsao G. Natural History of Cirrhosis. 2015, 13-20. DOI: 10.1007/978-3-319-13614-1_2.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsPrognostic stageHepatic venous pressure gradientNatural historyDifferent prognostic stagesRecurrent variceal hemorrhageVenous pressure gradientMulti-organ failureAbsence of varicesHepatorenal syndromeDecompensated cirrhosisRefractory ascitesVariceal hemorrhageHepatic encephalopathyLiver failureSpecific complicationsWorse prognosisDecompensated stageReversible diseaseCirrhosisPatientsVaricesPrognosisDecompensationAscitesComplications
2012
The presence of esophageal varices (EV), but not treatment with beta-blockers, is associated with a poorer survival in patients with cirrhosis and ascites
Zipprich A, Garcia-Tsao G, Seufferlein T, Dollinger M. The presence of esophageal varices (EV), but not treatment with beta-blockers, is associated with a poorer survival in patients with cirrhosis and ascites. Zeitschrift Für Gastroenterologie 2012, 50 DOI: 10.1055/s-0031-1295840.Peer-Reviewed Original Research
2011
Management: Cirrhotic Portal Hypertension
Lim J, Garcia-Tsao G. Management: Cirrhotic Portal Hypertension. 2011, 165-181. DOI: 10.1007/978-1-4419-8327-5_11.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsPortal hypertensionVariceal hemorrhageAcute variceal hemorrhageCirrhotic portal hypertensionBetter risk stratificationNovel pharmacotherapeutic agentsGastroesophageal varicesPortal pressureRisk stratificationMain complicationsNoninvasive markerPharmacotherapeutic agentsIndividualized careHypertensionVaricesHemorrhageSignificant mortalityCirrhosisSignificant improvementProphylaxisComplicationsPatientsRecurrenceMortality
2009
Incidence, Prevalence, and Clinical Significance of Abnormal Hematologic Indices in Compensated Cirrhosis
Qamar AA, Grace ND, Groszmann RJ, Garcia–Tsao G, Bosch J, Burroughs AK, Ripoll C, Maurer R, Planas R, Escorsell A, Garcia–Pagan J, Patch D, Matloff DS, Makuch R, Rendon G, Group P. Incidence, Prevalence, and Clinical Significance of Abnormal Hematologic Indices in Compensated Cirrhosis. Clinical Gastroenterology And Hepatology 2009, 7: 689-695. PMID: 19281860, PMCID: PMC4545534, DOI: 10.1016/j.cgh.2009.02.021.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientHematologic indicesCompensated cirrhosisBaseline hepatic venous pressure gradientWhite blood cell countChild-Pugh scorePredictors of deathPrimary end pointVenous pressure gradientDevelopment of varicesKaplan-Meier analysisBlood cell countCombination of leukopeniaBaseline thrombocytopeniaVariceal bleedingClinical decompensationEsophageal varicesPrognostic significanceTransplant surgeryClinical significanceLeukopeniaThrombocytopeniaCirrhosisCell countVarices
2007
Platelet count is not a predictor of the presence or development of gastroesophageal varices in cirrhosis
Qamar AA, Grace ND, Groszmann RJ, Garcia‐Tsao G, Bosch J, Burroughs AK, Maurer R, Planas R, Escorsell A, Garcia‐Pagan J, Patch D, Matloff DS, Makuch R, Group P. Platelet count is not a predictor of the presence or development of gastroesophageal varices in cirrhosis. Hepatology 2007, 47: 153-159. PMID: 18161700, DOI: 10.1002/hep.21941.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientPresence of GEVsGastroesophageal varicesPlatelet countPortal hypertensionMild portal hypertensionSpecific platelet countDouble-blind trialVenous pressure gradientTime of endoscopyHVPG changesCompensated cirrhosisHVPG measurementNoninvasive testsCurrent guidelinesNoninvasive markerPatientsSecondary analysisLongitudinal evaluationCirrhosisEsophagogastroduodenoscopyHypertensionVaricesPresent longitudinal studyLongitudinal studyHepatic Venous Pressure Gradient Predicts Clinical Decompensation in Patients With Compensated Cirrhosis
Ripoll C, Groszmann R, Garcia–Tsao G, Grace N, Burroughs A, Planas R, Escorsell A, Garcia–Pagan J, Makuch R, Patch D, Matloff DS, Bosch J, Group P. Hepatic Venous Pressure Gradient Predicts Clinical Decompensation in Patients With Compensated Cirrhosis. Gastroenterology 2007, 133: 481-488. PMID: 17681169, DOI: 10.1053/j.gastro.2007.05.024.Peer-Reviewed Original ResearchMeSH KeywordsAgedAscitesEsophageal and Gastric VaricesFemaleFollow-Up StudiesGastrointestinal HemorrhageHepatic EncephalopathyHumansHypertension, PortalKaplan-Meier EstimateLiver CirrhosisMaleMiddle AgedPortal PressurePredictive Value of TestsPrognosisProportional Hazards ModelsProspective StudiesRisk AssessmentRisk FactorsROC CurveSensitivity and SpecificitySeverity of Illness IndexTime FactorsConceptsHepatic venous pressure gradientVenous pressure gradientClinical decompensationPortal hypertensionMedian hepatic venous pressure gradientEnd-stage liver diseaseDiagnostic capacityBaseline laboratory testsPredictors of decompensationChild-Pugh scoreDevelopment of varicesMedical record reviewEnd of studyMedian followCompensated cirrhosisLiver transplantationLiver diseaseRecord reviewStudy terminationDecompensationPatientsCirrhosisMultivariate analysisVaricesHypertension
2006
Portal hypertension
Garcia-Tsao G. Portal hypertension. Current Opinion In Internal Medicine 2006, 5: 399-407. DOI: 10.1097/01.mog.0000218962.93806.9a.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsPortal hypertensionVariceal bleedingTransjugular intrahepatic portosystemic shuntRecurrent variceal bleedingLarge-volume paracentesisSpontaneous bacterial peritonitisEndoscopic variceal ligationIntrahepatic portosystemic shuntHepatorenal syndromeRefractory ascitesBacterial peritonitisVariceal ligationSpecific complicationsPortosystemic shuntHypertensionΒ-blockersComplicationsTrialsBleedingVaricesAscitesDiagnosisRecent findingsRecent studiesCirrhosis
2000
Portal hypertension
Garcia-Tsao G. Portal hypertension. Current Opinion In Gastroenterology 2000, 16: 282-289. PMID: 17023887, DOI: 10.1097/00001574-200005000-00012.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsComplications of cirrhosisPortal hypertensionHyperdynamic circulationHepatic insufficiencyCirrhosis portal hypertensionChronic liver diseaseHepatorenal syndromeRenal vasoconstrictionSinusoidal hypertensionGastroesophageal varicesPeripheral vasodilatationHemodynamic abnormalitiesPortosystemic encephalopathyLiver diseaseSodium retentionNeurohumoral systemsHypertensionCirrhosisMajor syndromesVasodilatationComplicationsSyndromeInsufficiencyVaricesVasoconstriction
1998
Portal hypertension
Garcia-Tsao G. Portal hypertension. Current Opinion In Gastroenterology 1998, 14: 256-264. DOI: 10.1097/00001574-199805000-00012.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsComplications of cirrhosisPortal hypertensionHepatic insufficiencySpontaneous bacterial peritonitisInsufficiency contributesVariceal hemorrhageCirrhotic patientsBacterial peritonitisLive diseaseHypertensionMajor syndromesCirrhosisComplicationsInsufficiencyVaricesPeritonitisAscitesHemorrhagePatientsSyndromeDisease
1997
The portal pressure response to beta-blockade is greater in cirrhotic patients without varices than in those with varices
Escorsell A, Ferayorni L, Bosch J, Garcia-Pagan J, Garcia-Tsao G, Grace N, Rodes J, Groszmann R. The portal pressure response to beta-blockade is greater in cirrhotic patients without varices than in those with varices. Gastroenterology 1997, 112: 2012-2016. PMID: 9178694, DOI: 10.1053/gast.1997.v112.pm9178694.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientPortal pressure responseVenous pressure gradientCirrhotic patientsPortal pressurePortal hypertensionDevelopment of varicesSingle oral dosePressure responseSystemic hemodynamicsEsophageal varicesOral doseVaricesPatientsAbstractTextBeneficial effectsHypertensionTimololHgEarly stagesPressure gradientCirrhosisAIMSHemodynamicsDosePortal hypertension
Garcia-Tsao G. Portal hypertension. Current Opinion In Gastroenterology 1997, 13: 263-270. DOI: 10.1097/00001574-199705000-00013.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsComplications of cirrhosisPortal hypertensionHepatic insufficiencyChronic liver diseaseSpontaneous bacterial peritonitisInsufficiency contributesVariceal hemorrhageCirrhotic patientsPortosystemic encephalopathyBacterial peritonitisLiver diseaseHypertensionMajor syndromesCirrhosisComplicationsEnd stageInsufficiencyVaricesPeritonitisAscitesHemorrhagePatientsEncephalopathyPathophysiologySyndrome
1992
Elective treatment of bleeding varices with the Sugiura operation over 10 years
Orozco H, Mercado M, Takahashi T, Hernández-Ortiz J, Capellán^S J, Garcia-Tsao G. Elective treatment of bleeding varices with the Sugiura operation over 10 years. The American Journal Of Surgery 1992, 163: 585-589. PMID: 1595838, DOI: 10.1016/0002-9610(92)90562-6.Peer-Reviewed Original ResearchConceptsSugiura operationOperative mortality rateEarly postoperative periodDevascularization operationEncephalopathy ratesLow rebleedingPortal hypertensionPostoperative periodElective treatmentTherapeutic armamentariumOperative procedureEsophageal fistulaMortality ratePatientsRebleedingHypertensionVaricesFistulaTransectionGroupHepatopathyArmamentariumShunt
1990
Hemodynamic events in a prospective randomized trial of propranolol versus placebo in the prevention of a first variceal hemorrhage
Groszmann R, Bosch J, Grace N, Conn H, Garcia-Tsao G, Navasa M, Alberts J, Rodes J, Fischer R, Bermann M, Rofe S, Patrick M, Lerner E. Hemodynamic events in a prospective randomized trial of propranolol versus placebo in the prevention of a first variceal hemorrhage. Gastroenterology 1990, 99: 1401-1407. PMID: 2210246, DOI: 10.1016/0016-5085(90)91168-6.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientVenous pressure gradientVariceal hemorrhageEsophageal varicesHemodynamic eventsBaseline valuesHeart rateFirst variceal hemorrhagePropranolol-treated groupPropranolol-treated patientsTrial of propranololAdministration of propranololBeginning of therapyRate of survivalPortal hypertensionVariceal bleedingCirrhotic patientsPharmacological therapyVariceal sizeProtective effectMortality ratePatientsPlaceboPropranololVarices