Relationship between systemic arterial pressure and portal pressure and efficacy evaluation of indirect pressure measurement in esophageal varices in patients with portal hypertension

This article provides the results of portal pressure, esophageal vein diameter and venous wall thickness minimally invasive original measurement technique, which allows to estimate the degree of portal hypertension in esophageal varices in patients with liver cirrhosis. In 51 patient with portal hypertension due to liver cirrhosis (class B and C) the grade of esophageal varices was estimated using endoscopic ultrasound combined with endoscopic balloon manometry during endoscopic variceal ligation performed under deep monitored sedation. Measuring the diameter of the most dilated vein and the pressure in it using endoscopic balloon manometry has lead to improvement in endoscopic variceal ligation quality. Due to discovered correlation between venous pressure and vein diameter the grade of portal hypertension in some cases can be evaluated without measuring the pressure itself. This method of indirect pressure measurement in esophageal varices may reduce the risk of endoscopic variceal ligation and may help to optimize pharmacological management of this procedure.