Study on Portal Vein Pressure Gradient Measurement Under Endoscopic Ultrasound Guidance for Gastric Fundal Varices

Second Affiliated Hospital, School of Medicine, Zhejiang University25 enrolled

Overview

This study aimed to evaluate the feasibility and safety of direct gastric variceal pressure measurement in patients with large spontaneous portosystemic shunts, and to determine whether the gastric variceal pressure gradient (GVPG)-defined as directly measured gastric variceal pressure (GVP) minus hepatic vein pressure (HVP)-offers superior predictive value for bleeding risk compared to conventional HVPG and EUS-PPG in this challenging patient population.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Esophageal and Gastric Varices

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * (1) age≥18 years; (2) hospitalized patients with a confirmed diagnosis of cirrhosis with gastric varices and large spontaneous shunts based on clinical, laboratory, and imaging findings; and (3) provided written informed consent for all diagnostic and therapeutic procedures. Exclusion Criteria: * (1) significant coagulopathy, defined as an international normalized ratio (INR) \> 1.5; (2) severe thrombocytopenia (platelet counts \< 20×10\^9/L); (3) presence of severe systemic comorbidities, such as active sepsis, decompensated heart failure, or severe chronic obstructive pulmonary disease; (4) psychiatric disorders precluding procedure cooperation; (5) concurrent malignant tumors; or (6) refusal to undergo hepatic venous pressure gradient (HVPG) or endoscopic ultrasound-guided portal pressure gradient (EUS-PPG) measurement.

Locations (1)

Outcomes

Primary Outcomes

HVPG

Time frame: From enrollment to the end of treatment at 4 weeks

EUS-PPG

Time frame: From enrollment to the end of treatment at 4 weeks

GVPG

Time frame: From enrollment to the end of treatment at 4 weeks