Abstract:
BACKGROUND AND AIMS:Hepatic venous pressure gradient (HVPG) currently serves as a surrogate for portal pressure measurement but has many limitations. We developed a novel technique for rapid and direct portal pressure measurements using a digital pressure wire delivered through an EUS-guided 22-gauge FNA needle. Our aims were to evaluate (1) the short-term safety and technical feasibility, (2) procedural duration and subjective workload assessment, and (3) accuracy compared with a transjugular criterion standard approach. METHODS:The subjects were Yorkshire pigs, weighing 40 to 55 kg. The portal vein was identified by using a linear array echoendoscope and accessed with a commercially available 22-gauge FNA needle preloaded with a digital pressure wire. Access was confirmed by portal venography. Mean digital pressure measurements were recorded over 30 to 60 seconds, and the National Aeronautics and Space Administration Task Load Index was scored. The control measurements were conventional transjugular catheterization with a balloon occlusion catheter to obtain free and wedged hepatic pressures, with subsequent HVPG calculation. RESULTS:The total time required for EUS identification and needle access of the portal vein, venography, and digital pressure measurement was less than 5 minutes in 5 of 5 pigs. The National Aeronautics and Space Administration Task Load Index scores revealed a low subjective workload. Baseline portal pressure measurements via EUS ranged from 5 mm Hg to 10 mm Hg (mean, 6.4 mm Hg). HVPG measurements were consistently ±1 mm Hg of portal pressure. CONCLUSIONS:This study is the first report of direct EUS-guided portal pressure measurements by using a digital pressure wire. This method is routinely performed in minutes and provides real-time pressure tracings via wireless transmission. This novel approach for direct portal pressure measurement has the potential to replace traditional indirect HVPG measurements.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Schulman AR,Thompson CC,Ryou Mdoi
10.1016/j.gie.2015.11.038subject
Has Abstractpub_date
2016-04-01 00:00:00pages
817-20issue
4eissn
0016-5107issn
1097-6779pii
S0016-5107(15)03171-5journal_volume
83pub_type
杂志文章abstract::Overgrowth of an esophageal prosthesis by cancer is a late complication of insertion which presents a difficult management problem. We have treated 14 such patients; 9 had Celestin tubes and 5 Atkinson tubes in situ for a median of 7 months. The median patient age was 75 years; 3 had squamous cell carcinomas and 11 ad...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(92)70383-6
更新日期:1992-03-01 00:00:00
abstract:OBJECTIVE:The chemical composition and clinical significance of white bile in patients with malignant biliary obstruction were evaluated in a prospective study. METHODS:Consecutive patients (January 1996 through December 1997) with inoperable malignant biliary obstruction underwent endoscopic placement of 10F straight...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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journal_title:Gastrointestinal endoscopy
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journal_title:Gastrointestinal endoscopy
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doi:10.1016/j.gie.2011.08.031
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abstract::From June 1991 to September 1992, 16 patients (mean age, 72 +/- 5 years) were treated with intra-corporeal laser lithotripsy (ICL). Thirteen patients had choledocholithiasis with at least one stone larger than 20 mm; 3 patients had intra-hepatic lithiasis. All other methods, including mechanical lithotripsy, extra-cor...
journal_title:Gastrointestinal endoscopy
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更新日期:1994-05-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
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更新日期:1998-03-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2008-11-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,meta分析
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journal_title:Gastrointestinal endoscopy
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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更新日期:2015-09-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2014.03.021
更新日期:2014-09-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1996-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/s0016-5107(04)02224-2
更新日期:2005-01-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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更新日期:2011-02-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.10.007
更新日期:2009-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2005-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-07-05 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
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更新日期:2016-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-10-08 00:00:00
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更新日期:2010-09-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,meta分析
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更新日期:2012-10-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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更新日期:2002-09-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2013.10.035
更新日期:2014-05-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1067/mge.2003.66
更新日期:2003-02-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.05.021
更新日期:2005-11-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(94)70214-4
更新日期:1994-07-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.06.037
更新日期:2005-12-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.08.042
更新日期:2008-04-01 00:00:00