PMID- 34890694
OWN - NLM
STAT- MEDLINE
DCOM- 20220414
LR  - 20221105
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 95
IP  - 4
DP  - 2022 Apr
TI  - Simultaneous EUS-guided portosystemic pressure measurement and liver biopsy 
      sampling correlate with clinically meaningful outcomes.
PG  - 703-710
LID - S0016-5107(21)01866-6 [pii]
LID - 10.1016/j.gie.2021.11.037 [doi]
AB  - BACKGROUND AND AIMS: The measurement of the portosystemic pressure gradient (PSG) 
      in patients with advanced liver disease is helpful to assess the severity of 
      portal hypertension (PH) and predict adverse clinical outcomes. EUS-guided PSG 
      (EUS-PSG) measurement is a novel tool to assess PSG in all patients with advanced 
      liver disease. We sought to assess the safety, feasibility, and technical success 
      of simultaneous EUS-PSG measurement and EUS-guided liver biopsy sampling using a 
      single-center experience. METHODS: Patients with suspected liver disease or 
      cirrhosis were enrolled prospectively from 2020 to 2021. EUS-PSG was measured by 
      calculating the difference between the mean portal pressure and the mean hepatic 
      vein pressure. PH was defined as PSG >5 mm Hg and clinically significant PH as 
      PSG >/=10 mm Hg. The primary outcomes were procedural technical success rate and 
      correlation of EUS-PSG with fibrosis stage obtained from concurrent EUS-guided 
      liver biopsy sampling and the correlation of EUS-PSG with patients' imaging, 
      clinical, and laboratory findings. The secondary outcome was occurrence of 
      procedural adverse events (AEs). RESULTS: Twenty-four patients were included in 
      the study. PSG measurement and EUS-guided liver biopsy sampling were successful 
      in 23 patients (technical success rate of 96%) and 24 patients (100% success), 
      respectively. Analysis revealed a significant association between both PSG and 
      liver stiffness measured on transient elastography (P = .011) and fibrosis-4 
      score (P = .026). No significant correlation was found between the fibrosis stage 
      on histology and measured PSG (P = .559). One mild AE of abdominal pain was 
      noted. Additionally, EUS-PSG was predictive of clinically evident PH. 
      CONCLUSIONS: Simultaneous EUS-PSG measurement and EUS-guided liver biopsy 
      sampling were both feasible and safe and correlated with clinically evident PH 
      and noninvasive markers of fibrosis.
CI  - Copyright (c) 2022 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Hajifathalian, Kaveh
AU  - Hajifathalian K
AD  - Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New 
      York-Presbyterian Hospital, New York, New York, USA.
FAU - Westerveld, Donevan
AU  - Westerveld D
AD  - Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New 
      York-Presbyterian Hospital, New York, New York, USA.
FAU - Kaplan, Alyson
AU  - Kaplan A
AD  - Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New 
      York-Presbyterian Hospital, New York, New York, USA.
FAU - Dawod, Enad
AU  - Dawod E
AD  - Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New 
      York-Presbyterian Hospital, New York, New York, USA.
FAU - Herr, Andrea
AU  - Herr A
AD  - Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New 
      York-Presbyterian Hospital, New York, New York, USA.
FAU - Ianelli, Mallory
AU  - Ianelli M
AD  - Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New 
      York-Presbyterian Hospital, New York, New York, USA.
FAU - Saggese, Allysa
AU  - Saggese A
AD  - Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New 
      York-Presbyterian Hospital, New York, New York, USA.
FAU - Kumar, Sonal
AU  - Kumar S
AD  - Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New 
      York-Presbyterian Hospital, New York, New York, USA.
FAU - Fortune, Brett E
AU  - Fortune BE
AD  - Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New 
      York-Presbyterian Hospital, New York, New York, USA.
FAU - Sharaiha, Reem Z
AU  - Sharaiha RZ
AD  - Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New 
      York-Presbyterian Hospital, New York, New York, USA.
LA  - eng
PT  - Journal Article
DEP - 20211207
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
CIN - Gastrointest Endosc. 2022 Aug;96(2):387. PMID: 35843675
CIN - Gastrointest Endosc. 2022 Oct;96(4):690-691. PMID: 36116847
MH  - Biopsy
MH  - *Endosonography
MH  - Humans
MH  - *Hypertension, Portal/complications
MH  - Liver Cirrhosis/complications
EDAT- 2021/12/11 06:00
MHDA- 2022/04/15 06:00
CRDT- 2021/12/10 20:14
PHST- 2021/06/08 00:00 [received]
PHST- 2021/11/13 00:00 [accepted]
PHST- 2021/12/11 06:00 [pubmed]
PHST- 2022/04/15 06:00 [medline]
PHST- 2021/12/10 20:14 [entrez]
AID - S0016-5107(21)01866-6 [pii]
AID - 10.1016/j.gie.2021.11.037 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2022 Apr;95(4):703-710. doi: 10.1016/j.gie.2021.11.037. Epub 
      2021 Dec 7.