Arteriographic Studies of Splenic and Hepatic Arteries in Portal Hypertension

Abstract

The radii of the splenic and proper hepatic arteries were estimated by means of selective celiac arteriography in cases of portal hypertension and of splenomegaly without portal hypertension.The results were evaluated in comparison with normal arteriograms.The estimated radii of the splenic arteries were in satisfactory agreement with the histometrical ones. It was concluded that the splenic and hepatic arterial flow could be proportional to the 2.7th power of the radii of the respective arteries on arteriograms, as in the histo metrical study.1,2 In cases of portal hypertension and appreciable increase in the radius of the splenic artery was demonstrated.In splenomegaly without portal hypertension, as in idiopathic thrombocytopenic purpura, hemolytic jaundice, such an increase in the radius of the splenic artery was not observed.In portal hypertension, the radius of the splenic artery could be correlated with the splenic weight, portal pressure, the grade of decrease in the portal pressure after splenecto my and the length of the splenic artery.In cases of liver fibrosis, dilatation of the splenic artery was not usually accompanied by dilatation of the proper hepatic artery, whereas in liver cirrhosis with or without giant splenomegaly, dilatation was noted not only in the splenic artery but also in the proper hepatic artery as well.arteriogram;portal hypertension;splenic blood flowIn previous publications, we reported on the estimation of splenic blood flow in cases of portal hypertension, especially in hepatic fibrosis (Banti's syndrome) and liver cirrhosis from the histometrical determination of the radius of the splenic artery. Splenic blood flow' was calculated therefrom by the formula of Suwa et al.2 It was pointed out in these reports that the splenic blood flow thus calculated was in good agreement with that obtained by dye dilution technic3 prior to splenectomy.In the present study, the radius of the splenic artery was measured in patients with portal hypertension on the films of selective celiac arteriography and the obtained values were compared with those of direct histometrical measurement on the splenic artery after splenectomy.4 The relation of the arterial radii to portal pressure and splenic weight was investigated in an attempt to gain insight into the significance of dilatation of the splenic artery in the pathogenesis of this syndrome.

Doppler ultrasonography combined with transient elastography improves the non-invasive assessment of fibrosis in patients with chronic liver diseases

“…This is similar to several studies in the field, which show a progressive increase in the hepatic artery diameter and blood flow in patients with more severe fibrosis, as a result of a progressive arterialisation of the liver circulation [37,38].…”

Association Between Changes in Splanchnic Hemodynamics and Risk Factors of Portal Venous System Thrombosis After Splenectomy with Periesophagogastric Devascularization

“…Increased portal pressure contributes to formation of portosystemic venous collaterals in order to decompress the portal vein system, which results in esophagogastric varices [ 6 , 7 ]. Additionally, the splanchnic and systemic hemodynamics, including portal vein, splenic vessel, and hepatic artery system, varies in cirrhotic patients with concomitant portal hypertension (PH) [ 8 – 11 ]. Although the data is not comprehensive, the splanchnic hemodynamic disorder of cirrhotic patients with concomitant PH in a few studies reveals the significance of increased splenic artery flow and decreased hepatic artery flow [ 8 – 14 ].…”

Interaction between the Splenic and Hepatic Arteries in Portal Hypertension

“…splenic artery; hepatic artery; portal flow Dilatation of the splenic artery in splenomegalic disorders is especially pronounced in cases of portal hypertension. In previous reports of ours (Yamauchi 1968;Yamauchi et al 1970) a remarkable increase in the radii of the splenic arteries in periportal fibrosis accompanied by increased blood flow and concomitant narrowing of the proper hepatic artery was arteriographically or histometrically demonstrated.The purpose of this paper is to examine possible interaction between the splenic and hepatic arterial systems in the clinical and experimental portal hypertension. …”