Measurement of hepatic venous pressure gradient revisited: Catheter wedge vs balloon wedge techniques
Aims: To evaluate the accuracy of measurement of hepatic venous pressure gradient by catheter wedge as compared to balloon wedge (the gold standard). Materials and Methods: Forty-five patients having a clinical diagnosis of intrahepatic portal hypertension were subjected to the two different types of pressure measurements (catheter wedge and balloon wedge) during transjugular liver biopsy under fluoroscopic guidance. Statistical Analysis: Spearman′s rank correlation coefficient, Bland-Altman plot for agreement, and single measure intraclass correlation were used for analysis of data. Results: There was a close correlation between the results obtained by both the techniques, with highly significant concordance (P < 0.0001). Hepatic venous pressure gradients as measured by the catheter wedge technique were either equal to or less than those obtained by the balloon wedge technique. Conclusions: The difference in hepatic venous pressure gradients measured by the two techniques is insignificant.
KeywordsBalloon wedge hepatic venous pressure - catheter wedge hepatic venous pressure - free hepatic venous pressure - hepatic venous pressure gradient
Artikel online veröffentlicht:
30. Juli 2021
© 2011. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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- 1 Barth KH, Udoff EJ. Transfemoral balloon catheterization for hepatic wedge pressure measurements. Radiology 1980;135:779-80.
- 2 Jaime Bosch, Gennaro D′Amico. Portal Hypertension and non surgical management. Schiff′s disease of liver. 10 th ed. Vol. 1. Philadelphia, USA: Lippincott Williams & Wilkins; 2007. p. 436-9
- 3 Groszmann r. Measurement of portal pressure: When, How and Why to Do It? Clin Liver Dis 2006;10:499-512.
- 4 Groszmann RJ, Wongcharatrawee S. The hepatic venous pressure gradient: Anything worth doing should be done right. Hepatology 2004;39:280-2.
- 5 Boyer TD. WHVP: Ready for prime Time. Hepatology 2006;43:405-6.
- 6 Spearman C. The proof and measurement of association between two things. Am J Psychol 1987;100:441-71.
- 7 Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res 1999;8:135-60.
- 8 Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307-10.
- 9 Fisher RA. Statistical methods for research workers. 12 th edition. New York: Hafner publishing company; 1954. p. 211-47.
- 10 Thomas D, Boyer J. Michael Henderson. Portal Hypertension and bleeding esophageal varices, Hepatology. 4 th ed. Vol. 1. Philadelphia, USA: Saunders; 2003. p. 581-630.
- 11 Madhu K, Avinash B, Ramakrishna B, Eapen CE, Shyamkumar NK, Zachariah U, et al. Idiopathic non-cirrhotic intrahepatic portal hypertension: Common cause of cryptogenic intrahepatic portal hypertension in a Southern Indian tertiary hospital. Indian J Gastroenterol 2009;28:83-7.
- 12 D′Amico G, Garcia-Pagan JC, Luca A, Bosch J. Hepatic vein pressure gradient reduction and prevention of variceal bleeding in cirrhosis: A systematic review. Gastroenterology 2006;131:1611-24.