Endoscopic Ultrasound-Guided Interventions for the Measurement and Treatment of Portal Hypertension

Abstract

The number of endoscopic ultrasound (EUS)-guided interventions is rapidly growing within advanced endoscopy. EUS offers high-resolution imaging of mediastinal and intra-abdominal vasculature, which can be targeted for various interventions, hence a growing number of studies have explored EUS-guided vascular catheterization. Potential clinical applications of EUS-guided portal venous access include angiography, measurement of the portosystemic pressure gradient, and EUS-guided transhepatic intrahepatic portosystemic shunt creation. This article reviews different devices and techniques used in these applications.

Keywords: Endoscopic ultrasound; Hepatic venous portal gradient; Portal pressure gradient; Portal vein; Portal vein sampling; Transhepatic intrahepatic portosystemic shunt.