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The Balloon Catheter Method and the End-hole Catheter Method in the Measurement of Hepatic Venous Pressure Gradient:

Jian-An Yu1, Si-Wei Yang1, Yu Wang2

  • 1Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.

Cardiovascular and Interventional Radiology
|July 26, 2024
PubMed

Insights

The end-hole catheter method more accurately measures hepatic venous pressure gradient (HVPG) in cirrhosis patients compared to the balloon catheter method. It also offers superior screening for bleeding risk, especially when intrahepatic veno-venous shunts are absent.

Area of Science:

  • Hepatology
  • Medical Devices
  • Clinical Measurement

Background:

  • Hepatic venous pressure gradient (HVPG) is crucial for managing cirrhosis complications.
  • Accurate HVPG measurement is essential for risk stratification and treatment decisions.
  • Existing methods for HVPG measurement may have discrepancies, particularly in the presence of shunts.

Purpose of the Study:

  • To compare the accuracy and reliability of the balloon catheter method versus the end-hole catheter method for HVPG measurement in cirrhosis patients.
  • To evaluate the impact of intrahepatic veno-venous shunts (IHVS) on HVPG measurements obtained by both methods.
  • To assess the predictive ability of each method for identifying patients at risk of bleeding.

Main Methods:

  • A consecutive cohort of 145 cirrhosis patients underwent HVPG measurements using both balloon and end-hole catheter methods.
  • HVPG measurements were compared with portal vein pressure gradient (PPG) obtained via transjugular intrahepatic portosystemic shunt (TIPS) in 61 patients.
  • Statistical analyses were performed to assess differences, consistency, and predictive capabilities, considering the presence or absence of IHVS.

Main Results:

  • Both methods showed significant differences compared to PPG (P < 0.001), with end-hole catheter values closer to PPG.
  • In patients without IHVS, measurements from both methods were highly correlated.
  • In the IHVS group, a significant difference was observed (P < 0.001), with lower measurements by the balloon catheter method.
  • The end-hole catheter method demonstrated a higher screening capability for bleeding risk (75.90% vs. 72.86%).

Conclusions:

  • HVPG measurements differ significantly between balloon and end-hole catheter methods when compared to PPG.
  • The end-hole catheter method offers superior screening for bleeding risk in cirrhosis patients.
  • Intrahepatic veno-venous shunts can lead to underestimation of HVPG when using the balloon catheter method.
Abstract

Keywords:
CirrhosisHepatic venous pressure gradientIntrahepatic venous shuntPortal hypertensionThe balloon catheter methodThe end-hole catheter method

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