Interventional Endoscopic Ultrasound (EUS) | October 2026-05 Portal Pressure Measurement

Video Transcription

Video Summary

The speaker presented EUS-guided portal pressure gradient (PPG) measurement as a tool in endohepatology, using a case of a patient with severe obesity and compensated MASH cirrhosis who was being evaluated for endoscopic weight-loss treatment. CT and endoscopy showed gastric varices; PPG was 16.4 mmHg, indicating high bleeding and mortality risk. After carvedilol reduced the PPG to 8.3, the team proceeded with endoscopic gastric remodeling.<br /><br />The procedure measures hepatic and portal venous pressures with a heparin-flushed needle and manometer, taking repeated readings and averaging them. Discussion covered room setup, patient positioning, anesthesia, antibiotic use, safety thresholds, and troubleshooting. Speakers emphasized confirming stable readings, clearing the needle well, checking the equipment for bubbles or loose connections, and becoming familiar with hepatic vascular anatomy. PPG may help guide management and determine whether patients are suitable for bariatric endoscopic procedures.

Meta Tag

Concept EUS-Guided Portal Pressure Gradient Measurement

Concept Portal Hypertension

Concept Clinically Significant Portal Hypertension

Concept Equipment Setup

Concept Hepatic Vein

Keywords

EUS-guided portal pressure gradient

endohepatology

gastric varices

compensated MASH cirrhosis

carvedilol

endoscopic gastric remodeling

EUS-Guided Portal Pressure Gradient Measurement

Portal Hypertension

Clinically Significant Portal Hypertension

Equipment Setup

Hepatic Vein