EUS-guided Response Assessment to NSBB

Korábbi kezelés

• Patients with cirrhosis and HCC Portopulmonary hypertension Portal or splanchnic venous thrombosis Prior TIPS Prior liver transplantation
• Previous total or partial splenectomy
• Patients with contraindications for non-selective beta-blocker therapy, including but not limited to the following baseline vital signs:
  • Systolic BP <100 mmHg HR <50 bpm

Más betegség

• Non-cirrhotic portal hypertension or pre-sinusoidal liver disease
• Known infection that is not controlled by medical intervention
• Diagnosis of portal vein thrombosis during EUS
• Evidence of active gastrointestinal bleeding during EUS

Laborértékek

• Cholestatic liver disease with total bilirubin >3 mg/dl
• INR >1.7 or platelet count <50.000 per mm3
• eGFR <50 ml/min/1.73m2 (CKD-EPI formula) Anatomical criteria

Életkor

• Patient is <18 or >80 years of age

Egyéb

• General criteria
• Patient is pregnant, breast-feeding or planning to become pregnant during the course of the study
• Patient is unwilling or unable to sign the informed consent
• Patients in whom general anesthesia or endoscopic procedures are contraindicated Medical criteria
• Patients with reduced life expectancy described by an ASA score of 4 or 5
• Anatomical abnormalities that prevent access via EUS-guided puncture to the hepatic vein or intrahepatic portion of the portal vein, including anatomy that predisposes to difficult to reach puncture sites or an inadequate needle angle.
• Visualization of ascites interposing the puncture tract on EUS

• Patients with a clinical and/or pathological diagnosis of compensated cirrhosis.
• Patients with suspicion of CSPH and thus indication for NSBB treatment.
• Patients not yet on NSBB therapy.
• Patients willing and able to undergo repeated HVPG and EUS-guided pressure measurements as per protocol.