Advances in portal hypertension management: Evolution of the Baveno guidelines

Figure 1  Surveillance of esophageal varices according to Baveno VI.

Figure 2 Management of acute bleeding from esophageal varices, gastric varices, and portal hypertensive gastropathy according to Baveno VII. ¹Other factors should also be considered such as cardiovascular disorders, age, hemodynamic status, and ongoing bleeding. ²Blood sodium levels should be monitored. ³Duration of treatment interruption should be determined individually, depending on the indications for anticoagulant use. ⁴It is recommended to ensure the availability of an on-call endoscopist 24/7. ⁵To exclude splanchnic vein thrombosis and hepatocellular carcinoma and to map portosystemic collateral circulation for treatment guidance. APC: Argon plasma coagulation; CT: Computed tomography; EVL: Endoscopic variceal ligation; GAVE: Gastric antral vascular ectasia; GI: Gastrointestinal; GOV: Gastroesophageal varices; IGV: Intragastric varices; MRI: Magnetic resonance imaging; PHG: Portal hypertensive gastropathy; PPIs: Proton pump inhibitors; PTFE: Polytetrafluoroethylene; RBCs: Red blood cells; TIPS: Transjugular intrahepatic portosystemic shunt.

Figure 3 Prevention of recurrent variceal bleeding according to Baveno VII guidelines. EBL: Endoscopic band ligation; EVL: Endoscopic variceal ligation; NSBBs: Non-selective beta-blockers; PHG: Portal hypertensive gastropathy; TIPS: Transjugular intrahepatic portosystemic shunt.

Figure 4 Key milestones and innovations introduced in Baveno I-VII (with publication dates). ¹Indicates the planned date of the upcoming Baveno VIII meeting. AEVB: Acute esophageal variceal bleeding; cACLD: Compensated advanced chronic liver disease; EBL: Endoscopic band ligation; NSBBs: Non-selective beta-blockers; SSM: Spleen stiffness measurement.