Measurement of hepatic venous pressure gradient revisited: Catheter wedge vs balloon wedge techniques

Abstract

Aims:To evaluate the accuracy of measurement of hepatic venous pressure gradient by catheter wedge as compared to balloon wedge (the gold standard).Materials and Methods:Forty-five patients having a clinical diagnosis of intrahepatic portal hypertension were subjected to the two different types of pressure measurements (catheter wedge and balloon wedge) during transjugular liver biopsy under fluoroscopic guidance.Statistical Analysis:Spearman's rank correlation coefficient, Bland–Altman plot for agreement, and single measure intraclass correlation were used for analysis of data.Results:There was a close correlation between the results obtained by both the techniques, with highly significant concordance (P < 0.0001). Hepatic venous pressure gradients as measured by the catheter wedge technique were either equal to or less than those obtained by the balloon wedge technique.Conclusions:The difference in hepatic venous pressure gradients measured by the two techniques is insignificant.

Comprehensive Predictors of Portal Pressure from Functional Liver Reserve in Patients Who Underwent Hepatectomy

“…The current standard for measuring portal hypertension and severity is usually measurement of the hepatic venous pressure gradient. Tables 2 and 3 Measurement of this gradient is safe and relatively simple to perform but is invasive and costly [5,6]. Clinical features associated with the presence of portal hypertension include ascites, splenomegaly, and venous dilatation as caput medusa [20].…”

“…Gradient flow velocity or volume of the cardiac tricuspid valve on ultrasonography can be applied to predict pulmonary arterial pressure [4]. The gradient of hepatic portal venous pressure can be evaluated by various means [5][6][7]. However, indirectly evaluating PP itself remains to be difficult.…”

Prediction of portal pressure from intraoperative ultrasonography

“…The current standard for measuring portal hypertension and severity is usually the measurement of the hepatic venous pressure gradient. Measurement of this gradient is safe and relatively simple to perform, but it is invasive and costly [6,7]. Tc-GSA scintigraphy and PP [25], suggesting that HH15 and LHL15 are reliable predictors of PP.…”

“…In cases where evaluation is performed for pulmonary hypertension, the gradient flow velocity or the volume of the cardiac tricuspid valve on ultrasonography can be used to predict the pulmonary arterial pressure [5]. In addition, the gradient of the hepatic venous-portal pressure can be evaluated by various means [6][7][8]. However, indirectly evaluating PP itself remains difficult.…”

Intrahepatic portal vein blood volume estimated by non-contrast magnetic resonance imaging for the assessment of portal hypertension

“…The gold-standard method to measure the portal venous pressure involves an invasive catheterization of Magnetic Resonance Imaging xxx (2015) xxx-xxx the cava and hepatic veins, and the measurement of the hepatic venous pressure gradient (HVPG) [3][4][5][6][7]. This method is invasive and uses ionizing radiation, and the need of sedative agents could also modify the hemodynamic response.…”