EUS-guided Portal Pressure Gradient (PPG) Measurement: a Potential Alternative to the Traditional HVPG

Launched by FUNDACIO PRIVADA MON CLINIC BARCELONA · Mar 4, 2025

Keywords

ClinConnect Summary

This clinical trial is exploring a new way to measure pressure in the blood vessels of the liver, known as portal pressure, in patients with liver disease and portal hypertension (high blood pressure in the liver). The researchers want to see if a method called endoscopic ultrasound-guided portal pressure gradient (EUS-PPG) is as accurate and safe as the traditional method, hepatic venous pressure gradient (HVPG). They will compare the results from both methods in the same group of patients to determine if EUS-PPG can be a reliable and less invasive alternative.

To be eligible for this study, participants must be adults aged 18 to 85 with a history of liver disease and portal hypertension or suspected cirrhosis that requires pressure measurement. Those who join the study will undergo both the EUS-PPG and HVPG measurements within a week, while also receiving standard care for their condition. Throughout the trial, researchers will monitor participants for any potential complications related to the procedures, such as bleeding or infection. This trial is not yet recruiting, but it aims to provide important information on safer ways to assess liver pressure in patients.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Subjects must be 18 to 85 years of age inclusive, at the time of signing the informed consent form.
• • Subjects who have a history of liver disease and portal hypertension or suspected cirrhosis requiring HVPG measurement.
• • Subjects capable of giving signed informed consent.
• Exclusion Criteria:
• • Pregnancy.
• • Significant bleeding risk (International Normalized Ratio (INR) \> 1.5 OR platelet count \< 50000).
• • Presence of active gastrointestinal bleeding at the time of screening
• • History of any blood thinner consumption (e.g. warfarin, heparin, novel roal anticoagulants) within the last 5 days.
• • Presence of massive ascites causing abdominal distension or requiring frequent therapeutic paracentesis.
• • Subjects having received previous Transjugular Intrahepatic Portosystemic Shunt (TIPS) or Surgical Portosystemic Shunt.
• • Hepatocellular carcinoma not meeting Milan Criteria.
• • Presence of portal vein thrombosis or another suspected component of presinusoidal portal hypertension.
• • Presence of extra-hepatic cancer, terminal disease, or severe comorbidities significantly limiting life expectancy or affecting study participation.
• • Stenosis or surgical anatomical alterations of the gastrointestinal tract that could preclude endoscopic access with the echoendoscope.