{"title":"Endoscopic ultrasound in portal hypertension: navigating venous hemodynamics and treatment efficacy","authors":"Irina Dragomir, Cristina Pojoga, Claudia Hagiu, Radu Seicean, Bogdan Procopet, Andrada Seicean","doi":"10.1093/gastro/goae082","DOIUrl":null,"url":null,"abstract":"Portal hypertension-related complications increase mortality in patients, irrespective of its etiology. Classically, endoscopic ultrasound (EUS) was used to assess the portal venous system and collaterals, considering size and hemodynamic parameters, which correlate with portal hypertension (PH) and related complications. Furthermore, therapeutic EUS guides treatment interventions, such as embolization of the gastric varices through coil placement and tissue adhesive injection, yielding encouraging clinical results. Recently, the direct measurement of portal pressure, emerging as an alternative to hepatic venous pressure gradient, has shown promise, and further research in this area is anticipated. In this review, we aimed to provide a detailed description of various possibilities for diagnosing vascular anatomy and hemodynamics in PH and actual knowledge on the EUS usefulness for PH vessel-related complications. Also, future promises for this field of endo-hepatology are discussed.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"190 1","pages":""},"PeriodicalIF":3.8000,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastroenterology Report","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/gastro/goae082","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Portal hypertension-related complications increase mortality in patients, irrespective of its etiology. Classically, endoscopic ultrasound (EUS) was used to assess the portal venous system and collaterals, considering size and hemodynamic parameters, which correlate with portal hypertension (PH) and related complications. Furthermore, therapeutic EUS guides treatment interventions, such as embolization of the gastric varices through coil placement and tissue adhesive injection, yielding encouraging clinical results. Recently, the direct measurement of portal pressure, emerging as an alternative to hepatic venous pressure gradient, has shown promise, and further research in this area is anticipated. In this review, we aimed to provide a detailed description of various possibilities for diagnosing vascular anatomy and hemodynamics in PH and actual knowledge on the EUS usefulness for PH vessel-related complications. Also, future promises for this field of endo-hepatology are discussed.
无论病因如何，门静脉高压相关并发症都会增加患者的死亡率。传统上，内窥镜超声（EUS）用于评估门静脉系统和瓣膜，考虑大小和血液动力学参数，这些参数与门静脉高压（PH）和相关并发症相关。此外，治疗性 EUS 还可指导治疗干预措施，如通过放置线圈和注射组织粘合剂对胃静脉曲张进行栓塞，取得了令人鼓舞的临床效果。最近，直接测量门静脉压力作为肝静脉压力梯度的一种替代方法，已显示出良好的前景，这一领域的进一步研究值得期待。在这篇综述中，我们旨在详细描述诊断 PH 血管解剖和血流动力学的各种可能性，以及 EUS 对 PH 血管相关并发症的实际作用。此外，我们还讨论了肝内科这一领域的未来前景。
期刊介绍：
Gastroenterology Report is an international fully open access (OA) online only journal, covering all areas related to gastrointestinal sciences, including studies of the alimentary tract, liver, biliary, pancreas, enteral nutrition and related fields. The journal aims to publish high quality research articles on both basic and clinical gastroenterology, authoritative reviews that bring together new advances in the field, as well as commentaries and highlight pieces that provide expert analysis of topical issues.
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