Measurement of hepatic venous pressure gradient revisited: Catheter wedge vs balloon wedge techniques

AIMS To evaluate the accuracy of measurement of hepatic venous pressure gradient by catheter wedge as compared to balloon wedge (the gold standard). MATERIALS AND METHODS Forty-five patients having a clinical diagnosis of intrahepatic portal hypertension were subjected to the two different types of pressure measurements (catheter wedge and balloon wedge) during transjugular liver biopsy under fluoroscopic guidance. STATISTICAL ANALYSIS Spearman's rank correlation coefficient, Bland-Altman plot for agreement, and single measure intraclass correlation were used for analysis of data. RESULTS There was a close correlation between the results obtained by both the techniques, with highly significant concordance (P < 0.0001). Hepatic venous pressure gradients as measured by the catheter wedge technique were either equal to or less than those obtained by the balloon wedge technique. CONCLUSIONS The difference in hepatic venous pressure gradients measured by the two techniques is insignificant.