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Summary
Digital subtraction angiography (DSA) effectively visualizes portal venous anatomy and collaterals for portal hypertension patients undergoing surgery. This safe and cost-effective imaging method aids in preoperative planning and postoperative assessment of shunt patency.
Area of Science:
- Radiology
- Vascular Imaging
- Gastroenterology
Background:
- Portal hypertension requires precise imaging for surgical planning.
- Conventional angiography can be invasive and less informative for complex venous anatomy.
Purpose of the Study:
- To evaluate the efficacy of combined intravenous (IV) and intraarterial (IA) digital subtraction angiography (DSA) for preoperative planning in portal hypertension.
- To assess shunt patency postoperatively using DSA.
Main Methods:
- Combined selective IV-DSA and IA-DSA were performed on 42 portal hypertension patients.
- IV-DSA visualized the hepatic venous system, left renal vein, and inferior vena cava.
- IA-DSA evaluated portal venous anatomy, flow direction, and collaterals.
Main Results:
- Technically adequate DSA studies were obtained in all 50 examined patients (42 preoperatively, 8 postoperatively).
- DSA provided clear visualization for surgical planning and postoperative assessment.
- Patient or organ motion did not limit study quality.
Conclusions:
- Combined IV-IA DSA is an efficacious, safe, and cost-effective alternative to conventional angiography for portal hypertension.
- DSA is suitable for both preoperative planning and postoperative shunt evaluation.