The gold standard for assessment of portal hypertension is the measurement of the HVPG. The technique should be standardized to be accurate and reproducible. The assessment of HVPG in patients with cirrhosis provides a unique opportunity to assess the presence and severity of portal hypertension and therefore predict the patient’s outcome. HVPG assessment can guide patient management for prevention of hepatic decompensation, prophylaxis, and treatment of variceal hemorrhage, assessment of postoperative risk after hepatic resection or non-hepatic surgery, and residual risk of decompensation upon etiological cure. The management of patients with cirrhosis poses complex clinical challenges. A personalized approach is likely to achieve the best results, and the measurement of HVPG should be used to improve prognostic individual patient stratification and treatment decisions. In patients undergoing TIPS procedures, PPG measurement is imperative both before and after TIPS. If the clinical condition of the patient does not improve after TIPS, a repeat measurement of PPG with possible intervention is recommended.
HVPG as a Gold Standard: Accuracy Is Essential / Garcia-Pagan, J. C.; Schepis, F.; Gaba, R. C.; Zanetto, A.; Perez-Campuzano, V.; Haskal, Z. J.; Ferral, H.. - (2022), pp. 45-60. (Intervento presentato al convegno 7th Baveno Consensus Workshop: Personalized Care in Portal Hypertension tenutosi a na nel 2022) [10.1007/978-3-031-08552-9_5].
HVPG as a Gold Standard: Accuracy Is Essential
Schepis F.;
2022
Abstract
The gold standard for assessment of portal hypertension is the measurement of the HVPG. The technique should be standardized to be accurate and reproducible. The assessment of HVPG in patients with cirrhosis provides a unique opportunity to assess the presence and severity of portal hypertension and therefore predict the patient’s outcome. HVPG assessment can guide patient management for prevention of hepatic decompensation, prophylaxis, and treatment of variceal hemorrhage, assessment of postoperative risk after hepatic resection or non-hepatic surgery, and residual risk of decompensation upon etiological cure. The management of patients with cirrhosis poses complex clinical challenges. A personalized approach is likely to achieve the best results, and the measurement of HVPG should be used to improve prognostic individual patient stratification and treatment decisions. In patients undergoing TIPS procedures, PPG measurement is imperative both before and after TIPS. If the clinical condition of the patient does not improve after TIPS, a repeat measurement of PPG with possible intervention is recommended.
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