EUS-PPG Measured Distal to the Thrombus: A Reliable Way to Detect the Pressure Gradient in Patients With Cirrhosis and Portal Vein Thrombosis.
- 1Department of Gastroenterology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
- 2Endoscopy Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Abstract
Objectives
In patients with portal vein thrombosis (PVT), hepatic venous pressure gradient (HVPG) does not accurately reflect portal pressure. This study aimed to evaluate the application of endoscopic ultrasound (EUS)-guided portal pressure gradient (PPG) in cirrhotic patients with PVT.Methods
In patients with cirrhosis who had gastroesophageal varices (GEV) and PVT were included. The PPG proximal to the PVT (Pro-PVT PPG), PPG distal to the PVT (Dis-PVT PPG), and gastric variceal pressure gradient (GVPG) were measured by puncturing the target vessels under the guidance of EUS. The pressure gradients measured using different methods were compared and correlated with clinical characteristics.Results
A total of 51 patients with GEV and PVT were included in the final analysis. There was a substantial agreement between Dis-PVT PPG and GVPG, with an intraclass correlation coefficient (ICC) of 0.693 (0.514-0.813). Dis-PVT PPG and GVPG were significantly higher in the patients with bleeding history than in those without (17.0 mmHg vs. 11.3 mmHg, and 18.0 mmHg vs. 7.0 mmHg, p < 0.01 for both). In addition, patients with a Dis-PVT PPG ≥ 12 mmHg had a higher incidence of red sign (odds ratio [OR] = 5.6, 95% confidence interval [CI] = 1.6-20.2) and bleeding history (OR = 7.0, 95% CI = 2.0-26.4).Conclusions
Dis-PVT PPG may be a preferred index that reflects the status of portal hypertension in cirrhotic patients with PVT and is associated with a bleeding history of GEV.
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BibTeX
@article{wei2026eusppg,
title = {{EUS-PPG Measured Distal to the Thrombus: A Reliable Way to Detect the Pressure Gradient in Patients With Cirrhosis and Portal Vein Thrombosis.}},
author = {Wei Wei and Laijuan Chen and Runya Ying and Meng Xue},
journal = {Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society},
year = {2026},
month = nov,
doi = {10.1111/den.70325},
url = {https://europepmc.org/article/MED/42968412},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - EUS-PPG Measured Distal to the Thrombus: A Reliable Way to Detect the Pressure Gradient in Patients With Cirrhosis and Portal Vein Thrombosis.
AU - Wei Wei
AU - Laijuan Chen
AU - Runya Ying
AU - Meng Xue
PY - 2026
DA - 2026/11/01
JO - Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
DO - 10.1111/den.70325
UR - https://europepmc.org/article/MED/42968412
AB - Objectives In patients with portal vein thrombosis (PVT), hepatic venous pressure gradient (HVPG) does not accurately reflect portal pressure. This study aimed to evaluate the application of endoscopic ultrasound (EUS)-guided portal pressure gradient (PPG) in cirrhotic patients with PVT.Methods In patients with cirrhosis who had gastroesophageal varices (GEV) and PVT were included. The PPG proximal to the PVT (Pro-PVT PPG), PPG distal to the PVT (Dis-PVT PPG), and gastric variceal pressure gradient (GVPG) were measured by puncturing the target vessels under the guidance of EUS. The pressure gradients measured using different methods were compared and correlated with clinical characteristics.Results A total of 51 patients with GEV and PVT were included in the final analysis. There was a substantial agreement between Dis-PVT PPG and GVPG, with an intraclass correlation coefficient (ICC) of 0.693 (0.514-0.813). Dis-PVT PPG and GVPG were significantly higher in the patients with bleeding history than in those without (17.0 mmHg vs. 11.3 mmHg, and 18.0 mmHg vs. 7.0 mmHg, p < 0.01 for both). In addition, patients with a Dis-PVT PPG ≥ 12 mmHg had a higher incidence of red sign (odds ratio [OR] = 5.6, 95% confidence interval [CI] = 1.6-20.2) and bleeding history (OR = 7.0, 95% CI = 2.0-26.4).Conclusions Dis-PVT PPG may be a preferred index that reflects the status of portal hypertension in cirrhotic patients with PVT and is associated with a bleeding history of GEV.
SN - 0915-5635
SN - 1443-1661
ER -