Spleen stiffness measurement rules out high-risk varices in patients with chronic portal vein thrombosis without cirrhosis.

Spleen stiffness measurement ≤40 kPa accurately rules out high-risk varices in patients with chronic portal vein thrombosis without cirrhosis, enabling endoscopy sparing.

• Why it matters: Current screening methods for high-risk varices are invasive and may be unnecessary for many patients with low risk, highlighting the need for reliable non-invasive alternatives in this population.
• What they did: The study analyzed 346 patients with chronic PVT without cirrhosis across multiple centers, using vibration-controlled transient elastography to measure spleen stiffness and evaluate its predictive value for high-risk varices.
• The result: Spleen stiffness measurement ≤40 kPa showed high sensitivity and negative predictive value, allowing up to 43% of endoscopies to be avoided with minimal missed high-risk varices, potentially improving patient care and reducing procedure-related risks.