The response of the variceal pressure to pharmacotherapy predicts the risk of variceal bleeding in cirrhotic patients

Nevens,; Atti, E. Abd Ei; Setijoso, E.; Bogaerts, Katleen; Verbeke,; Fevery, Johan

doi:10.1097/00042737-199912000-00180

Cited by 1 publication

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“… 83 A follow‐up study has shown that a medication‐induced decrease in HVPG to below 12 mmHg, or at least 20% of the initial value, is needed to be protective. 86 In a prospective follow‐up study of 51 cirrhotic patients with large varices treated with propranolol or the combination propranolol and isosorbide dinitrate, we observed that a VP during treatment of above 14 mmHg was associated with a bleeding incidence of 39%; if the VP was below 14 mmHg only 9% of the patients bled. 87 Hepatic Venous Pressure Gradient determination can not adequately measure the effect of a drug in non‐cirrhotic portal hypertension.…”

Section: Introductionmentioning

confidence: 92%

Oesophageal varices: Assessment of the risk of bleeding and mortality

Fevery¹,

Nevens²

2000

J of Gastro and Hepatol

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Patients with oesophageal varices run a high risk of bleeding and even death, however rates of bleeding and mortality vary greatly. Indeed, a number of patients with varices never bleed. Prophylactic therapy is effective, but can be associated with side‐effects. It remains to be determined which patients are at high risk of bleeding and require treatment. In addition, since non‐response to medical therapy has been reported to occur in 20–40% of patients, the effect of a given prophylactic drug, or combinations of drugs, needs to be tested. A review is given of available methods of assessment. The Hepatic Venous Pressure Gradient, and measurements of the variceal pressure, are two proven methods, and the latter has the advantages of being non‐invasive and having value in presinusoidal portal hypertension.

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Section: Introductionmentioning

confidence: 92%