EUS-guided portal pressure gradient measurement with a simple novel device: a human pilot study
Background and Aims: Portal hypertension is a serious adverse event of liver cirrhosis. Recently, we developed a simple novel technique for EUS-guided portal pressure gradient (PPG) measurement (PPGM). Our animal studies showed excellent correlation between EUS-PPGM and interventional radiology-acqu...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-11-01
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| Series: | VideoGIE |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468448118301395 |
| _version_ | 1827877630246912000 |
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| author | Jason B. Samarasena, MD Jason Y. Huang, FRACP Takeshi Tsujino, MD, PhD Daniel Thieu, BSc Allen Yu, BSc Ke-Qin Hu, MD John Lee, MD Kenneth J. Chang, MD |
| author_facet | Jason B. Samarasena, MD Jason Y. Huang, FRACP Takeshi Tsujino, MD, PhD Daniel Thieu, BSc Allen Yu, BSc Ke-Qin Hu, MD John Lee, MD Kenneth J. Chang, MD |
| author_sort | Jason B. Samarasena, MD |
| collection | DOAJ |
| description | Background and Aims: Portal hypertension is a serious adverse event of liver cirrhosis. Recently, we developed a simple novel technique for EUS-guided portal pressure gradient (PPG) measurement (PPGM). Our animal studies showed excellent correlation between EUS-PPGM and interventional radiology-acquired PPGM. In this video we demonstrate the results of the first human pilot study of EUS-PPGM in patients with liver disease. Methods: EUS-PPGM was performed by experienced endosonographers using a linear echoendoscope, a 25-gauge FNA needle, and a novel compact manometer. The portal vein and hepatic vein (or inferior vena cava) were targeted by use of a transgastric or transduodenal approach. Feasibility was defined as successful PPGM in each patient. Safety was based on adverse events captured in a postprocedural interview. Results: Twenty-eight patients underwent EUS-PPGM with 100% technical success and no adverse events. PPG ranged from 1.5 to 19 mm Hg and had excellent correlation with clinical parameters of portal hypertension, including the presence of varices (P = .0002), PH gastropathy (P = .007), and thrombocytopenia (P = .036). Conclusion: This novel technique of EUS-PPGM using a 25-gauge needle and compact manometer is feasible and appears safe. Given the availability of EUS and the simplicity of the manometry setup, EUS-guided PPG may represent a promising breakthrough for procuring indispensable information in the management of patients with liver disease. |
| first_indexed | 2024-03-12T17:40:18Z |
| format | Article |
| id | doaj.art-0579d4f8c8a84738b881ac6c01a5792c |
| institution | Directory Open Access Journal |
| issn | 2468-4481 |
| language | English |
| last_indexed | 2024-03-12T17:40:18Z |
| publishDate | 2018-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | VideoGIE |
| spelling | doaj.art-0579d4f8c8a84738b881ac6c01a5792c2023-08-04T05:49:04ZengElsevierVideoGIE2468-44812018-11-01311361363EUS-guided portal pressure gradient measurement with a simple novel device: a human pilot studyJason B. Samarasena, MD0Jason Y. Huang, FRACP1Takeshi Tsujino, MD, PhD2Daniel Thieu, BSc3Allen Yu, BSc4Ke-Qin Hu, MD5John Lee, MD6Kenneth J. Chang, MD7H. H. Chao Comprehensive Digestive Disease Center, Division of Gastroenterology and Hepatology, University of California, Irvine, Orange, California, USAH. H. Chao Comprehensive Digestive Disease Center, Division of Gastroenterology and Hepatology, University of California, Irvine, Orange, California, USAH. H. Chao Comprehensive Digestive Disease Center, Division of Gastroenterology and Hepatology, University of California, Irvine, Orange, California, USAH. H. Chao Comprehensive Digestive Disease Center, Division of Gastroenterology and Hepatology, University of California, Irvine, Orange, California, USAH. H. Chao Comprehensive Digestive Disease Center, Division of Gastroenterology and Hepatology, University of California, Irvine, Orange, California, USAH. H. Chao Comprehensive Digestive Disease Center, Division of Gastroenterology and Hepatology, University of California, Irvine, Orange, California, USAH. H. Chao Comprehensive Digestive Disease Center, Division of Gastroenterology and Hepatology, University of California, Irvine, Orange, California, USAH. H. Chao Comprehensive Digestive Disease Center, Division of Gastroenterology and Hepatology, University of California, Irvine, Orange, California, USABackground and Aims: Portal hypertension is a serious adverse event of liver cirrhosis. Recently, we developed a simple novel technique for EUS-guided portal pressure gradient (PPG) measurement (PPGM). Our animal studies showed excellent correlation between EUS-PPGM and interventional radiology-acquired PPGM. In this video we demonstrate the results of the first human pilot study of EUS-PPGM in patients with liver disease. Methods: EUS-PPGM was performed by experienced endosonographers using a linear echoendoscope, a 25-gauge FNA needle, and a novel compact manometer. The portal vein and hepatic vein (or inferior vena cava) were targeted by use of a transgastric or transduodenal approach. Feasibility was defined as successful PPGM in each patient. Safety was based on adverse events captured in a postprocedural interview. Results: Twenty-eight patients underwent EUS-PPGM with 100% technical success and no adverse events. PPG ranged from 1.5 to 19 mm Hg and had excellent correlation with clinical parameters of portal hypertension, including the presence of varices (P = .0002), PH gastropathy (P = .007), and thrombocytopenia (P = .036). Conclusion: This novel technique of EUS-PPGM using a 25-gauge needle and compact manometer is feasible and appears safe. Given the availability of EUS and the simplicity of the manometry setup, EUS-guided PPG may represent a promising breakthrough for procuring indispensable information in the management of patients with liver disease.http://www.sciencedirect.com/science/article/pii/S2468448118301395 |
| spellingShingle | Jason B. Samarasena, MD Jason Y. Huang, FRACP Takeshi Tsujino, MD, PhD Daniel Thieu, BSc Allen Yu, BSc Ke-Qin Hu, MD John Lee, MD Kenneth J. Chang, MD EUS-guided portal pressure gradient measurement with a simple novel device: a human pilot study VideoGIE |
| title | EUS-guided portal pressure gradient measurement with a simple novel device: a human pilot study |
| title_full | EUS-guided portal pressure gradient measurement with a simple novel device: a human pilot study |
| title_fullStr | EUS-guided portal pressure gradient measurement with a simple novel device: a human pilot study |
| title_full_unstemmed | EUS-guided portal pressure gradient measurement with a simple novel device: a human pilot study |
| title_short | EUS-guided portal pressure gradient measurement with a simple novel device: a human pilot study |
| title_sort | eus guided portal pressure gradient measurement with a simple novel device a human pilot study |
| url | http://www.sciencedirect.com/science/article/pii/S2468448118301395 |
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