EUS-guided portal pressure measurement: how to make it more accurate?

Abstract

We read the recently published article, ‘How accurate is EUS-guided direct portal vein pressure measurement? A comparison with intraoperative measurements’ with great interest. In this article,1 Singh and colleagues compared the endoscopic ultrasound (EUS)-portal vein pressure (PVP) technique with direct intraoperative PVP measurement using a novel compact manometer (CM) and a conventional pressure transducer (CPT) connected to an ECG monitor. They found a reasonable correlation for EUS-PVP (0.72) and good correlation intraoperatively (0.96). However, the Pearson coefficient of 0.72 indicates only moderate correlation, which raises several concerns. EUS-guided portal pressure gradient (EUS-PPG)/PVP measurement is a novel technique to evaluate portal hypertension. However, several critical issues have been raised in previous studies, including the impact of sedation, the safety in advanced cirrhosis and lack of data to predict prognosis.2 Furthermore, we identify additional important considerations that warrant discussion. In the present study, pretransplant EUS-PVP obtained by CM and CPT (27.12±6.2 …