Clinical studyProspective Study Comparing Different Indirect Methods to Measure Portal Pressure
Section snippets
Study Design
The present prospective, single-center study was conducted at a tertiary liver unit from 2007 until 2010, and included all patients with cirrhosis considered for transjugular intrahepatic portosystemic shunt creation. The study protocol was approved by the institutional review board of University Hospitals Leuven (approval S 52654), and written informed consent was obtained before all procedures.
The primary aim of the present study was to compare the WHVP values measured with the use of an
Results
Clinical characteristics of the study cohort are summarized in Table 1. Pressure measurements in patients with sinusoidal PH are summarized in Table 2.
Agreement with direct PP was clearly greater for WHVP measurements with balloons than with end-hole catheters. The median absolute differences versus direct PP measurement were 6.0 mm Hg for WHVP measurement with an end-hole catheter and 2.0 mm Hg for WHVP measurement with an occlusion-balloon catheter (P < .0001). With the occlusion balloon, the
Discussion
Measurement and monitoring of PP and portal perfusion pressure gradient has become an important diagnostic and prognostic tool not only in daily clinical hepatologic practice, but also in hepatologic research dealing with evaluation of new drugs that interact with PP (2, 4). Therefore, the correct performance of the procedure and optimization of the technique of hepatic vein pressure gradient measurement is of the utmost importance. Indirect PP measurements with an end-hole catheter or
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Endovascular Assessment of Liver Hemodynamics in Patients with Cirrhosis Complicated by Portal Hypertension
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Application of CT-based radiomics in predicting portal pressure and patient outcome in portal hypertension
2020, European Journal of RadiologyCitation Excerpt :Direct measurement of portal pressure has been previously reported and can be achieved through a direct puncture of the portal vein, either through a percutaneous or transjugular approach. However, the direct approach is associated with a higher risk of complication including hepatic hemorrhage, portal vein thrombosis, and intrahepatic arteriovenous fistula [8,11]. Over the past decade, advancements in medical imaging analysis has grown exponentially.
Transvenous Pressure Measurements and Liver Biopsy
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2016, Blumgart's Surgery of the Liver, Biliary Tract and Pancreas: Sixth EditionFree Hepatic Vein Pressure Is Not Useful to Calculate the Portal Pressure Gradient in Cirrhosis: A Morphologic and Hemodynamic Study
2016, Journal of Vascular and Interventional RadiologyCitation Excerpt :This may be a situation in which morphologic changes of hepatic veins are more common than in patients with compensated cirrhosis (21). In addition, the WHVP was measured by using the end-hole technique, which may have a lower agreement with portal pressure compared with the balloon-occlusion method (22,23). However, absolute value differences between the two methods are small (24), and, at least in patients with advanced disease, the balloon-occlusion method may overestimate the portal pressure (24).
None of the authors have identified a conflict of interest.