Comparison of portal pressure with intravascular esophageal variceal pressure (IEVP) directly measured with a flexible indwelling needle.

Intravascular esophageal variceal pressure (IEVP) was measured using a flexible indwelling needle and compared with wedged hepatic venous pressure (WHVP) in 38 patients with liver cirrhosis. There was a high correlation between IEVP and WHVP; the former was lower than the latter, indicating the presence of a pressure gradient. Bleeders with a history of esophageal variceal rupture showed higher IEVP value than non-bleeders without a history of rupture, even though no difference in WHVP was observed. IEVP in the post-endoscopic injection sclerotherapy (EIS) group, even in those with endoscopic findings of large varices, was lower than that in the untreated groups. These results suggest that IEVP is a factor in the hemodynamics of patients with portal hypertension and that its measurement may be helpful in elucidating the pathophysiology of esophageal varices.