Advances in portal pressure measurement: Endoscopic techniques, challenges, and implications for liver transplantation

Figure 1 Technique of doing hepatic venous pressure gradient measurement. Hepatic vein (HV) pressure gradient measurement can be conducted using various approaches, including the trans-jugular, transfemoral, or peripheral antecubital vein method. Free HV pressure is measured by positioning the pressure-sensitive catheter at the distal portion of HV without occluding flow, while wedged HV pressure is measured by occluding blood flow by inflating the balloon catheter, thus providing a standing column to the portal via the hepatic sinusoid. HV pressure gradient measurement = wedged HV pressure - free HV pressure.