Endoscopic Ultrasound-Guided Portal Pressure Gradient Measurement, Is It Ready for Prime Time?

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Published Nov 28, 2022
DOI: https://doi.org/10.18103/mra.v10i11.3350

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Main Article Content

Muhammad Nadeem Yousaf, MD
Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, MO 65212
http://orcid.org/0000-0002-7979-8929 Xheni Deda, MD
Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, MO 65212
Ahmad Hassan Ali, MD
Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, MO 65212
Niraj James Shah, MD
Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, MO 65212
Ghassan M. Hammoud, MD, MPH
Department of Medicine, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, MO 65212

Abstract

Portal hypertension is a serious complication of advanced liver disease. Portal pressure gradient measurement accurately determines severity of portal hypertension, prognosis, and guides medical therapy. Conventionally, interventional radiology-guided hepatic venous portal gradient measures portal pressure gradient indirectly using specialized balloon catheter. Recent advances in endoscopy have paved the novel method of endoscopic ultrasound-guided direct portal pressure gradient measurement to evaluate portal hypertension with equivalent safety in both animal models and humans studies. With the expansion of Endo-Hepatology practice, a concept of “one stop shop” is becoming more popular which is a comprehensive endoscopic approach in the evaluation of chronic liver disease. During the same endoscopic procedure, patients could be evaluated for esophageal or gastric varices, portal hypertensive gastropathy, EUS-guided elastography, EUS-guided portal pressure measurement and EUS-guided liver biopsy when suspecting advanced liver disease or diagnosis remains uncertain. This article focuses on the overview of portal hypertension and EUS-guided interventions such as EUS-guided portal pressure measurement, EUS-guided elastography and EUS-guided liver biopsy in the evaluation of individuals with advanced liver disease.

Keywords: Endoscopic ultrasound, Fine needle biopsy, Portal hypertension, Portosystemic pressure gradient measurement, Hepatic venous pressure gradient, Cirrhosis

Article Details

How to Cite
YOUSAF, Muhammad Nadeem et al. Endoscopic Ultrasound-Guided Portal Pressure Gradient Measurement, Is It Ready for Prime Time?. Medical Research Archives, [S.l.], v. 10, n. 11, nov. 2022. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3350>. Date accessed: 22 dec. 2024. doi: https://doi.org/10.18103/mra.v10i11.3350.
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Issue
Vol 10 No 11 (2023): NOVEMBER ISSUE, VOl. 10 ISsue 11
Section
Research Articles

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References

1. Sanyal AJ, Bosch J, Blei A, Arroyo V. Portal hypertension and its complications. Gastroenterology. 2008;134(6):1715-1728.
2. Huang JY, Samarasena JB, Tsujino T, Chang KJ. EUS-guided portal pressure gradient measurement with a novel 25-gauge needle device versus standard transjugular approach: a comparison animal study. Gastrointest Endosc. 2016;84(2):358-362.
3. Giday SA, Clarke JO, Buscaglia JM, et al. EUS-guided portal vein catheterization: a promising novel approach for portal angiography and portal vein pressure measurements. Gastrointest Endosc. 2008;67(2):338-342.
4. Buscaglia JM, Dray X, Shin EJ, et al. A new alternative for a transjugular intrahepatic portosystemic shunt: EUS-guided creation of an intrahepatic portosystemic shunt (with video). Gastrointest Endosc. 2009;69(4):941-947.
5. Huang JY, Samarasena JB, Tsujino T, et al. EUS-guided portal pressure gradient measurement with a simple novel device: a human pilot study. Gastrointestinal endoscopy. 2017;85(5):996-1001.
6. Merkel C, Montagnese S. Hepatic venous pressure gradient measurement in clinical hepatology. Dig Liver Dis. 2011;43(10):762-767.
7. Rodrigues SG, Montani M, Guixé-Muntet S, De Gottardi A, Berzigotti A, Bosch J. Patients With Signs of Advanced Liver Disease and Clinically Significant Portal Hypertension Do Not Necessarily Have Cirrhosis. Clinical Gastroenterology and Hepatology. 2019;17(10):2101-2109.e2101.
8. Bosch J, Garcia-Pagán JC, Berzigotti A, Abraldes JG. Measurement of portal pressure and its role in the management of chronic liver disease. Semin Liver Dis. 2006;26(4):348-362.
9. Groszmann RJ, Bosch J, Grace ND, et al. Hemodynamic events in a prospective randomized trial of propranolol versus placebo in the prevention of a first variceal hemorrhage. Gastroenterology. 1990;99(5):1401-1407.
10. Albillos A, Bañares R, González M, et al. Value of the hepatic venous pressure gradient to monitor drug therapy for portal hypertension: a meta-analysis. The American journal of gastroenterology. 2007;102(5):1116-1126.
11. D'Amico G, Garcia-Pagan JC, Luca A, Bosch J. Hepatic vein pressure gradient reduction and prevention of variceal bleeding in cirrhosis: a systematic review. Gastroenterology. 2006;131(5):1611-1624.
12. Bochnakova T. Hepatic Venous Pressure Gradient. Clinical Liver Disease. 2021;17(3):144-148.
13. Maleux G, Willems E, Fieuws S, et al. Prospective study comparing different indirect methods to measure portal pressure. J Vasc Interv Radiol. 2011;22(11):1553-1558.
14. Samarasena JB, Huang JY, Tsujino T, et al. EUS-guided portal pressure gradient measurement with a simple novel device: a human pilot study. VideoGIE. 2018;3(11):361-363.
15. Sharma M, Somani P, Rameshbabu CS. Linear endoscopic ultrasound evaluation of hepatic veins. World J Gastrointest Endosc. 2018;10(10):283-293.
16. Lai L, Poneros J, Santilli J, Brugge W. EUS-guided portal vein catheterization and pressure measurement in an animal model: a pilot study of feasibility. Gastrointest Endosc. 2004;59(2):280-283.
17. Giday SA, Ko CW, Clarke JO, et al. EUS-guided portal vein carbon dioxide angiography: a pilot study in a porcine model. Gastrointest Endosc. 2007;66(4):814-819.
18. Buscaglia JM, Shin EJ, Clarke JO, et al. Endoscopic retrograde cholangiopancreatography, but not esophagogastroduodenoscopy or colonoscopy, significantly increases portal venous pressure: direct portal pressure measurements through endoscopic ultrasound-guided cannulation. Endoscopy. 2008;40(8):670-674.
19. Schulman AR, Thompson CC, Ryou M. EUS-guided portal pressure measurement using a digital pressure wire with real-time remote display: a novel, minimally invasive technique for direct measurement in an animal model. Gastrointest Endosc. 2016;83(4):817-820.
20. Schulman AR, Thompson CC, Ryou M. Endoscopic Ultrasound-Guided Direct Portal Pressure Measurement Using a Digital Pressure Wire with Real-Time Remote Display: A Survival Study. J Laparoendosc Adv Surg Tech A. 2017;27(10):1051-1054.
21. Fujii-Lau LL, Leise MD, Kamath PS, Gleeson FC, Levy MJ. Endoscopic ultrasound-guided portal-systemic pressure gradient measurement. Endoscopy. 2014;46 Suppl 1 UCTN:E654-656.
22. Zhang W, Peng C, Zhang S, et al. EUS-guided portal pressure gradient measurement in patients with acute or subacute portal hypertension. Gastrointest Endosc. 2021;93(3):565-572.
23. B. Martínez-Moreno LG, J. Martínez , A. Hurtado , S. Pascual , M. Rodríguez , C. Miralles , I. Herrera , P. Bellot , J. Martínez-Sempere , L. Compañy , F. Ruiz , C. Mangas , J.R. Aparicio. EUS-guided portal pressure gradient measurement (EUS-PPG). preliminary results compared with hepatic venous pressure gradient (HVPG) Endoscopy. 2022;54:s97.
24. Choi AY, Kolb J, Shah S, et al. Endoscopic ultrasound-guided portal pressure gradient with liver biopsy: 6 years of endo-hepatology in practice. J Gastroenterol Hepatol. 2022;37(7):1373-1379.
25. Choi AY, Chang KJ, Samarasena JB, et al. Endoscopic Ultrasound-Guided Porto-systemic Pressure Gradient Measurement Correlates with Histological Hepatic Fibrosis. Dig Dis Sci. 2022.
26. Hajifathalian K, Westerveld D, Kaplan A, et al. Simultaneous EUS-guided portosystemic pressure measurement and liver biopsy sampling correlate with clinically meaningful outcomes. Gastrointest Endosc. 2022;95(4):703-710.
27. Monachese M, Kolb JM, Chang KJ, et al. EUS GUIDED PORTO-SYSTEMIC PRESSURE GRADIENT EVALUATION PREDICTS LIVER HISTOLOGY AND CLINICAL PARAMETERS OF LIVER DISEASE: A LARGE MULTI-CENTER ENDOHEPATOLOGY STUDY. Gastrointestinal Endoscopy. 2022;95(6):AB237.