HVPG procedures were performed using the techniques described previously 7 (link),16 (link). The RUPS-100 (COOK, Bloomington, Indiana, USA) was placed in the inferior vena cava through the right internal jugular vein using the Seldinger technique. A 7-F balloon-tipped catheter (Edwards Lifesciences, Irvine, California, USA) was guided into the middle or the right hepatic vein. Both wedged hepatic venous pressure (WHVP) and free hepatic venous pressure (FHVP) were obtained and repeated three times, and the mean value was calculated. A small amount of radiologic contrast medium was injected manually to check the adequacy of occlusion. The difference between the mean WHVP and the mean FHVP was defined as HVPG. Heart rate and arterial pressures were monitored throughout the examination. The procedures for HVPG measurement were performed by chief physicians with over three-year experience.
7 f balloon tipped catheter
Manufactured by Edwards Lifesciences
Sourced in United States
The 7-F balloon-tipped catheter is a medical device designed for use in various diagnostic and interventional procedures. It features a 7-French (F) diameter and a balloon tip. The core function of this catheter is to facilitate the introduction and navigation of instruments or materials within the body.
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3 protocols using 7 f balloon tipped catheter
1
Measurement of Hepatic Venous Pressure Gradient
2
HVPG Measurement and Beta-Blocker Response Evaluation
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The HVPG measurement procedures were described as previous studies [14 (link), 15 (link)]: in brief, a 7-F balloon-tipped catheter (Edwards Lifesciences, Irvine, California, USA) was guided into the right or middle hepatic vein to measure the WHVP and FHVP, for three times, and the HVPG was calculated. After the initial HVPG measurement, the patients received oral propranolol or carvedilol. Carvedilol was started at 6.25 mg every day and increased to 12.5 mg every day one week later. Propranolol was started at 10 mg twice a day and increased by 10 mg stepwise daily until up to 40 mg twice a day or until the target dose was achieved. Blood pressure and pulse were closely monitored to maintain systolic blood pressure > 90 mmHg and heart rate > 55 bpm. Next, HVPG measurement was performed seven days later. Finally, patients were divided into different groups according to the change of FHVP and HVPG response. According to the guidelines [5 (link)], HVPG response was defined as a decrease of HVPG ≥ 10% or less than 12 mmHg. Patients were all treated by NSBBs combined with endoscopic therapy. Endoscopic therapy was performed every 1-4 weeks until the eradication of varices.
3
Measurement of Hepatic Venous Pressure Gradient
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Under local anesthesia and ultrasonographic guidance, a 9F venous catheter introducer (St. Jude Medical, Minnesota, USA) was placed in the right internal jugular vein using the Seldinger technique. Thereafter, a 7F balloon-tipped catheter (Edwards Lifesciences, Irvine, CA, USA) was advanced into the right hepatic vein to measure wedged and free hepatic venous pressures (WHVP and FHVP, respectively). HVPG was calculated as the difference between WHVP and FHVP and measured in triplicate. Clinically significant portal hypertension was defined as HVPG ≥10mmHg [10] . The operator was blinded to transient elastography results.
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