LAUSR

BACKGROUND AND AIMS EUS-guided portal pressure gradient (PPG) measurement is a novel method to evaluate portal hypertension severity. In this study, we determined the consistency between EUS-PPG and hepatic venous pressure gradient (HVPG) measurements in patients with acute or sub-acute portal hypertension. METHODS Twelve patients were prospectively enrolled. EUS-guided PPG measurements were performed using a 22-gauge fine-needle aspiration (FNA) needle and a central venous pressure measurement monitor. The HVPG measurements were performed using the transjugular approach. If an HVPG measurement was not attainable and the patient underwent transjugular intrahepatic portosystemic shunt (TIPS) treatment, a PPG was recorded as a reference standard during the procedure. We assessed the feasibility and safety of EUS-guided PPG and calculated the correlation between the 2 measurements. RESULTS EUS-PPG measurements were successful in 11 patients (91.7%). Subsequent HVPG measurements failed in 2 patients with Budd-Chiari syndrome (hepatic vein occlusion subtype), one of whom underwent TIPS to obtain transjugular PPG data. A small shunt was found during one HVPG measurement that introduced inaccuracy. Nine patients were included in the statistical analysis. The mean EUS-PPG and HVPG/PPG (transjugular) were 18.07±4.32 mm Hg and 18.82±3.43 mm Hg, respectively. Pearson's correlation coefficient (R) between the 2 methods was 0.923 (p<0.001). CONCLUSIONS EUS-guided PPG measurement using a 22-gauge FNA needle was a safe and accurate method to evaluate portal hypertension and has the potential to supplement the measurement of HVPG in liver diseases.