❓Non-selective beta-blockers #nsbb after TIPS-insertion?

Anja Tiede presents her findings on the impact of NSBB on hepatic decompensation and survival after portal pressure reduction via TIPS today at #EASLCongress 📍SAT-551 Anja Tiede #livertwitter

Exciting presentation at #EASL2023 !
Our #IPD #metaanalysis on #SpleenStiffnessMeasurament on CSPH diagnosis is now accepted in The Lancet Gastroenterology & Hepatology 🔜
✅ @BavenoVII➕SSM can identify patients should be treated with #NSBB
#LiverTwitter #EASLCongress

JESUS FUCKING CHRIST

Happy Friday! Is answer time ⏲️
Brought to you by CrushingGIBoards Board Member Maria Camila Fonseca, MD and Contributor Ali Khalifa, MD MSc (c)

Hepatic Sarcoidosis!!
🔥Question #1: Test ▶️ EGD
🔥Question #2: Treatment ▶️ NSBB + UDCA
Explanations 👇

Paradigm shifts in 🤔 about portal hypertension by ⁦Guadalupe GarciaTsao⁩

🔸Prevent decompensation (NSBB in patients with CPTH)
🔸 LSM and Plt 🚫 EGD for 👀varices
🔸NSBB can be used in ascites if MAP>65, SBP>90
🔸After TIPs: NSBB if HVPG is >12

#TLM23 ⁦AASLD⁩

Great case-based discussions with Dutch clinicians at the Meet-the-Expert session on BAVENO VII for the Dutch clinical practice, featuring expert Virginia from Hospital Clínic Barcelona at the Dutch Digestive Disease Days! Promote #HVPG #NSBB
EASLnews

Use of NSBB in cirrhosis Guadalupe GarciaTsao

🆕 Interesting meta-analysis on primary prevention of esophageal variceal bleeding in #cirrhosis patients:

⁉️ Which is better: NSBB, ligation (EVL), or both?

✳️ Better=survival
✳️ n=1400
✳️ Overall survival: NSBB=EVL
🔑 Survival in compensated cirrhosis: NSBB better than EVL
‼️…

BabyDogeCoin has burned 500 Trillion $BABYDOGE worth $1.3M.

#BabyDoge + Burn $BABYDOGE = 🚀🚀🚀 ⁉️😎 #BabyDoge #bitcoin #FLOKI #memecoin #nsbb

#plumenetwork x.com/plumenetwork/s…
John S. Bracken
今市隆二 RYUJI IMAICHI
@nsbb

Updates on interventional treatment of portal HTN by Juan G Abraldes
🔺First review pic 👇🏼
🔺start TIPS at 8 mmHg with goal below 12 (between PV and IVC)
🔺if pressure not below 12 with dilation to 10 mm, add NSBB
🔺see table 👇🏼for contraindications
#TLM23 #livertwitter …

Great discussion on the use on NSBB in cirrhosis and ⁦The Baveno Cooperation: an EASL Consortium⁩ guidelines today in Veldhoven!!! Thanks ⁦Minneke Coenraad⁩ Raoel Maan for the invitation 😊⁦

New from us - investigating adherence to guidelines after variceal bleeding, we find low rates of receiving both NSBB and repeat endoscopy in >3500 patients after vx bleeding. Only about 1/3 receive both - with better prognosis in those where this occurred. Out now in CGH

🤩We summarized the existing pharmacological therapies for #portalhtn in #cirrhosis Juan G Abraldes

🗝️Etiological tx
✅NSBB
✅Vasoactive agents
✅Statin & metformin

In Press here: shorturl.at/iGKRW

#Livertwitter #GITwitter #MedTwitter #medstudenttwitter

They gave beta-blockers to people and determined response by HVPG and then looked at hemodynamics using fancy MRI

pubmed.ncbi.nlm.nih.gov/37387503/

Tons of gold in here

1️⃣62% NSBB response
2️⃣response (⬇️hvpg) is unrelated to changes in systemic hemodynamics #
#LiverTwitter

Once patient has already decompensated but not bled, goal is preventing first varicella l hemorrhage

🔺In those with ascites who have never bled: goal is prevention of bleeding
🔺annual endoscopy is recommended
🔺High risk varices should be treated;NSBB preferred over…

🙂Always amazed from what you can learn from Juan G Abraldes

✅No specific MELD cut-off for pTIPS in AVB (clinical context matter)
✅Very low rebleed risk 6w post AVB after variceal eradication

#livertwitter AASLD #CLM24 Cirrhosis Care Alberta #nsbb #tips The Baveno Cooperation: an EASL Consortium

Rahul Kumar
Great data on impact of NSBB on incident ACLF
#TLM23
Prof Rajiv Jalan

1/ Paradigm shift in the use of NSBB❗️ by Guadalupe GarciaTsao 🙌🏻

1️⃣ NSBB (preferably carvedilol) should be considered for cACLD w/ CSPH to prevent decompensation

#TLM23 #LiverTwitter AASLD

Great #PortalHTN morning session! #TLM23 AASLD AASLD Foundation
- Decomp/HCC risk/yr w >25kPa 👉🏼19%/4.1%. - NSBB: Carvedilol is the way to go! (α, β1- and β2 blockade)
- ⬇️ PHTN: 🍾cessation, nutrition, 🏋🏻‍♀️, viral hep Tx