Hepatic venous pressure in practice: how, when, and why.

Hepatic venous pressure gradient (HVPG) measurement has evolved into an extremely useful procedure for the assessment of portal hypertensive patients and in the prediction and management of portal hypertension-related events. Although invasive and not widely available, its safety and reproducibility can be warranted when performed in referral centers and following accepted guidelines. Well-established manometric HVPG cut off are reliable targets in the therapy of portal hypertension. When adequately indicated and performed, HVPG measurement provides valuable information allowing to establish diagnosis, elaborate prognosis, evaluate therapy and, most importantly, to make therapeutic decisions in portal hypertensive patients.