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Updated: Jun 20, 2025
Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
Published on: June 18, 2020
Correlation of endoscopic ultrasound-guided portal pressure gradient measurements with hepatic venous pressure
Belén Martinez-Moreno1,2, Juan Martínez Martínez3, Iván Herrera2
1Endoscopy Unit, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain.
Background:
Hepatic venous portal gradient (HVPG) measurement remains the gold standard for estimating portal pressure gradient (PPG). This study aimed to evaluate the correlation between endoscopic ultrasound (EUS)-guided PPG and HVPG in patients with chronic portal hypertension.
Methods:
Patients with chronic portal hypertension in whom HVPG assessment was clinically indicated were invited to undergo transjugular HVPG and EUS-PPG with a 22-G needle in separate sessions for comparison. Intraclass correlation coefficient (ICC) and the Bland-Altman method were used to evaluate the agreement between techniques.
Results:
33 patients were included. No significant differences in technical success were observed: EUS-PPG (31/33, 93.9%) vs. HVPG (31/33, 93.9%). Overall, 30 patients who underwent successful EUS-PPG and HVPG were analyzed. Correlation between the two techniques showed an ICC of 0.82 (0.65-0.91). Four patients had major discrepancies (≥5 mmHg) between HVPG and EUS-PPG. No significant differences in adverse events were observed.
Conclusions:
The correlation between EUS-PPG and HVPG was almost perfect. EUS-PPG could be a safe and reliable method for direct PPG measurement in patients with cirrhosis and a valid alternative to HVPG.
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