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Endoscopy 2025; 57(01): 62-67
DOI: 10.1055/a-2369-0759
Innovations and brief communications

Correlation of endoscopic ultrasound-guided portal pressure gradient measurements with hepatic venous pressure gradient: a prospective study

Belén Martinez-Moreno 
1   Endoscopy Unit, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain
2   Gastroenterology Department, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain
,
Juan Martínez Martínez
3   Radiology Department, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain
,
Iván Herrera
2   Gastroenterology Department, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain
,
Lucía Guilabert 
2   Gastroenterology Department, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain
,
María Rodríguez-Soler
2   Gastroenterology Department, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain
,
Pablo Bellot
2   Gastroenterology Department, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain
,
Cayetano Miralles
2   Gastroenterology Department, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain
,
Sonia Pascual
2   Gastroenterology Department, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain
,
Javier Irúrzun
3   Radiology Department, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain
,
Pedro Zapater
4   Universidad Miguel Hernández de Elche, Alicante, Spain
,
José María Palazón-Azorín
4   Universidad Miguel Hernández de Elche, Alicante, Spain
,
Vicente Gil Guillén
4   Universidad Miguel Hernández de Elche, Alicante, Spain
,
Rodrigo Jover 
1   Endoscopy Unit, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain
2   Gastroenterology Department, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain
,
José R. Aparicio 
1   Endoscopy Unit, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain
2   Gastroenterology Department, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain
› Author Affiliations
Supported by: Fundacion SEED Research Grant in Gastrointestinal Endoscopy Clinical Trial: Registration number (trial ID): NCT05689268, Trial registry: ClinicalTrials.gov (http://www.clinicaltrials.gov/), Type of Study: Prospective comparative study
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Author commentary on Belén Martinez-Moreno et al.Endoscopy 2025; 57(01): v4-v4
DOI: 10.1055/a-2388-6548

Abstract

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.

Supplementary Material



Publication History

Received: 03 November 2023

Accepted after revision: 18 July 2024

Accepted Manuscript online:
18 July 2024

Article published online:
03 September 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Letter to this article:

Endoscopic ultrasound portal pressure gradient: possible discrepancies in metabolic dysfunction-associated steatotic liver disease-related portal pressure measurementsEndoscopy 2025; 57(03): 295-295
DOI: 10.1055/a-2423-4738

Letter to this article:

Beyond the hype: understanding the limits of perceived benefits in endoscopic ultrasound-guided portal pressure gradient measurementEndoscopy 2025; 57(06): 695-695
DOI: 10.1055/a-2535-9505

 

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