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.