Left Lateral Position and Supine Position in EUS-PPG Measurement

NCT ID: NCT06994039

Last Updated: 2025-11-18

Basic Information

• Recruitment Status: RECRUITING
• Total Enrollment: 30 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2025-06-03
• Study Completion Date: 2026-06-30

Brief Summary

The consistency of EUS-PPG measurements between left lateral decubitus and supine positions is unclear. In this rospective comparative study, we are aimed to evaluate the correlation between EUS-PPG measured in supine position (EUS-suPPG), and EUS-PPG measured in left lateral decubitus position (EUS-lePPG).

Detailed Description

The hepatic venous pressure gradient (HVPG) remains the gold standard for assessing portal hypertension, yet its clinical application faces several limitations. First, HVPG has restricted diagnostic scope, being unable to accurately evaluate prehepatic or presinusoidal portal hypertension. Second, the measurement process exposes both patients and physicians to radiation and involves complex techniques that preclude routine implementation in many hospitals. Finally, as HVPG indirectly estimates portal pressure through wedged hepatic venous pressure, its accuracy may be compromised by multiple factors including intrahepatic venous shunting, catheter insertion depth, excessive sedation or patient agitation during the procedure, and incomplete balloon occlusion of hepatic venous flow.

Endoscopic ultrasound-guided portal pressure gradient (EUS-PPG) measurement effectively addresses these limitations of HVPG. Current clinical studies on EUS-PPG have predominantly been conducted in the supine position. However, this position significantly increases the technical difficulty of endoscopic ultrasonography and complicates the simultaneous performance of endoscopic selective varices devascularization (EUS-ESVD) under single anesthesia. The consistency of EUS-PPG measurements between left lateral decubitus and supine positions requires further investigation.

This prospective comparative study enrolls hospitalized patients with liver cirrhosis complicated by esophagogastric varices. Prior to endoscopic treatment, we perform EUS-guided puncture of both the portal vein and hepatic vein using a 25G needle. Pressure transducers measure the portal venous pressure (PVP) and hepatic venous pressure (HVP), with their differential defined as EUS-PPG. Measurements obtained in supine position are designated EUS-suPPG, while those in left lateral decubitus position are termed EUS-lePPG. Statistical analysis will evaluate the correlation between EUS-suPPG and EUS-lePPG values, with postoperative monitoring for complications including infection and hemorrhage.

Conditions

Portal Pressure Gradient (PPG) Measurement Guided by Endoscopic Ultrasound (EUS); Varices, Esophageal; Gastric Varices

Study Design

• Observational Model Type: CASE_ONLY
• Study Time Perspective: PROSPECTIVE

Study Groups

EUS-suPPG

EUS-PPG measured in supine position

EUS-lePPG

Intervention Type: PROCEDURE

EUS-PPG measured in left lateral decubitus position

Interventions

EUS-lePPG

EUS-PPG measured in left lateral decubitus position

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• The gastroesophageal variceal patients hospitalized for endoscopic therapy, and are willing to sign the informed consent of measuring portal vein pressure gradient under endocsopic ultrasound.

Exclusion Criteria

• （1）unwilling to sign the informed consent （2）uncorrectable coagulopathy (INR>1.5) （3）uncorrectable thrombocytopenia (platelets <20,000/μL) （4）Bacteremia （5）Age<18,or≥81 （6）pregnancy

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Second Affiliated Hospital, School of Medicine, Zhejiang University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

The 2nd Affiliated Hospital, School of Medicine, Zhejiang University

Hangzhou, , China

Site Status: RECRUITING

Countries

China

Central Contacts

Meng Xue, PhD

Role: CONTACT

xuemeng@zju.edu.cn

8613958123617

Facility Contacts

Meng Xue, PhD

Role: primary

xuemeng@zju.edu.cn

8613958123617

Other Identifiers

2025-0437

Identifier Type: -

Identifier Source: org_study_id