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Related Experiment Videos

Portal pseudoperfusion: an angiographic illusion.

J T Fulenwider, B M Nordlinger, W J Millikan

    Annals of Surgery
    |March 1, 1979
    PubMed
    Summary

    Interposition shunts, like mesocaval, completely divert blood flow from the liver. This study clarifies "portal pseudoperfusion," a misinterpretation of angiography, showing these shunts eliminate portal perfusion.

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    Area of Science:

    • Vascular Surgery
    • Interventional Radiology
    • Hepatology

    Background:

    • Hemodynamics after mesosystemic shunts are poorly understood.
    • Conflicting reports exist on whether portal perfusion persists post-interposition shunts.

    Observation:

    • A randomized trial compared distal splenorenal shunt with interposition mesosystemic shunts.
    • Visceral angiography assessed hemodynamic changes in selective and non-selective shunts.
    • Patients with patent interposition shunts lost preoperative portal perfusion.

    Findings:

    • Interposition shunts (mesocaval, splenocaval, mesorenal) totally diverted portal venous blood flow.
    • Observed "portal pseudoperfusion" resulted from misinterpreting retrograde flow on angiography.
    • Selective hepatic arterial injections revealed hepatofugal portal venous flow.

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    Implications:

    • Existing literature may misinterpret angiographic findings regarding portal flow direction.
    • Interposition shunts effectively eliminate hepatic portal venous perfusion.
    • Understanding "portal pseudoperfusion" is crucial for accurate hemodynamic assessment and surgical planning.