Prognostic Markers in Patients Who Have Recovered from an Acute Variceal Bleeding: Role of HVPG Measurement

Variceal bleeding is one of the most severe complications of cirrhosis which despite recent advances in its management, still carries a high mortality. This situation is especially important in those patients surviving a first episode of variceal bleeding who are at higher risk of recurrent bleeding with an estimated 60% risk within one year after the first bleeding episode. Therefore, prevention of rebleeding remains a very important issue in the management of variceal bleeding. However, the risk of rebleeding is not homogeneous through the overall spectrum of bleeding patients, suggesting the need to stratify the rebleeding risk and to adjust the intensity of therapy according to this risk. In this manuscript we will review the utility of HVPG measurement in variceal rebleeding and its potential impact in tailoring therapy.