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Endoscopic Ultrasound-Guided Portal Pressure Measurement

  • Jason B. Samarasena
  • Allen R. Yu
  • Kenneth J. ChangEmail author
Chapter

Abstract

A growing number of studies have explored endoscopic ultrasound (EUS)-guided vascular catheterization due to the relative proximity of the gastrointestinal tract to the major blood vessels of the mediastinum and abdomen. In particular, EUS-guided access of the portal vein (PV) may be favorable given the relative difficulty of PV access via standard percutaneous routes. Two major diagnostic applications of EUS-guided vascular access include angiography and assessment of intravascular pressure. This review will outline the different devices and techniques employed to obtain angiographic visualization and/or direct pressure measurements of the portal circulation. Ease of access, safety, and important lessons learned from each approach will be highlighted.

Keywords

Endoscopic ultrasound Portal vein angiography Portal venous pressure Hepatic venous portal gradient Portal vein manometry 

Supplementary material

Video 16.1

Demonstration of a case of EUS-guided portal pressure gradient measurement (MP4 454141 kb)

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jason B. Samarasena
    • 1
  • Allen R. Yu
    • 1
  • Kenneth J. Chang
    • 1
    Email author
  1. 1.Department of Gastroenterology,H. H. Chao Comprehensive Digestive Disease CenterUniversity of California, Irvine Medical CenterOrangeUSA

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