Same Session Validation of a Custom-Built 22G With the Commercial 25G System for EUS-Guided Portal Pressure Gradient Measurement.

FIGURE 1. (A) Schematic layout of the commercially available 25G EUS‐PPG system (EchoTip insight). (a) 10mL‐syringe with saline for flushing of the system. (b) Proprietary pressure transducer with digital display showing pressure values in mmHg. (c) 3‐way tap for venting of the system. (d) 25G FNA needle. Created with biorender.com. (B) Schematic layout of the custom‐built 22G EUS‐PPG system. (a) 1000 mL saline in a pressure bag. (b) Pressure transducer with valve for leveling of the system. (c) Monitoring system to display pressure tracings. (d) 3‐way tap for venting of the system. (e) 22G FNA needle. Created with biorender.com.

FIGURE 2. Correlation of portal pressure gradient (PPG) values between 25G and 22G systems. (A) PPG values measured with the 25G system are plotted on the x‐axis and those measured with the 22G system on the y‐axis. A strong positive correlation was observed (r = 0.901, p < 0.001). Correlation of portal vein pressure (PVP) and hepatic vein pressure (HVP) values between 25G and 22G systems. (B) Portal vein pressures measured with the 25G system are plotted on the x‐axis and those measured with the 22G system on the y‐axis (r = 0.776, p < 0.001). (C) Hepatic vein pressures measured with the 25G system are plotted on the x‐axis and those measured with the 22G system on the y‐axis (r = 0.673, p < 0.001).

FIGURE 3. Pie chart of the agreement of the classification of clinically significant portal hypertension (CSPH, defined as EUS‐PPG > 10mmHg) between 25‐ and 22‐G systems. Agreement is plotted in blue and disagreement is plotted in orange.