Clinical value of hepatic vein catheterization. Improved pracability by balloon catheter technique

Area of Science:

• Hepatology
• Vascular Radiology
• Interventional Gastroenterology

Background:

• Portal hypertension is a serious complication of chronic liver disease.
• Accurate assessment of hepatic venous pressure is crucial for managing portal hypertension.
• Hepatic vein catheterization and pressure measurements are established diagnostic tools.

Purpose of the Study:

• To describe and evaluate the combined use of hepatic vein pressure measurement and hepatic occlusion phlebography.
• To assess the diagnostic utility of these combined techniques in patients with chronic liver disease and portal hypertension.
• To correlate pressure gradients with observed venous alterations.

Main Methods:

• Hepatic vein catheterization and pressure measurements were performed in 95 patients.
• Hepatic occlusion phlebography using a balloon catheter was employed.
• These methods were combined in 32 patients, including 63 with liver cirrhosis.

Main Results:

• Significant elevation of hepatic venous pressure gradients was observed in patients with liver cirrhosis.
• A decrease in pressure gradients was noted after portacaval and splenorenal shunt operations.
• Hepatic occlusion phlebography revealed alterations in hepatic veins exclusively in cirrhotic patients, correlating with pressure gradients.

Conclusions:

• Combined hepatic vein pressure measurements and hepatic occlusion phlebography are highly suitable for evaluating chronic liver disease.
• These techniques provide valuable insights into the severity of portal hypertension and venous changes.
• The combined approach aids in assessing the effectiveness of surgical interventions like shunts.