EUS-guided portal pressure gradient measurement: improving its safety and accuracy

Abstract Text We performed EUS-guided portal pressure gradient (EUS-PPG) with a dedícate 25G needle in 21 patients. Anticoagulants were withdrawn in 4 patients. Bilobar liver biopsies were also performed in 18 patients (86%). In 2 cases PPG was not obtained, for rapid breathing movements and for non-reliable pressure measurements (probably for bending of the needle and use of the elevator). In one case the 25G needle passed in close proximity to the hepatic artery. We found difficulty punction the hepatic and the portal vein (one and two cases, respectively). We present these cases aiming to make the procedure more safe and accurate (video).