Occlusive Hepatic Venous Catheterization in the Study of the Normal Liver, Cirrhosis of the Liver and Noncirrhotic Portal Hypertension

Abstract

T HE anatomic location of the portal vein is such that measurements of portal pressure in manl have been possible only at laparotomy. The relative inaccessability of the portal vein has been a particular handicap in the study of Laennec's eirrhosis inl which the effects of deranged intrahepatic circulation with resultant portal hypertension are of great importance in the course and ultimate outcome of the disease.Various indirect methods' 2 for giving an indication of portal pressure have not proved fully satisfactory and the need for a suitable techini(qIue for estimating portal venous pressure has become more pressing with the advent of direct surgical means for attacking the problem of portal hypertension. A method for direct needling of the portal vein in unanesthetized man has recently been reported3 but its applicability would appear to be limited.

The Hemodynamic Effects of Hexamethonium Bromide in the Dog, With Special Reference to “Splanchnic Pooling” 1

“…Radioactivity was assayed by means of a GeigerMuller end-window tube and conventional scaler. Splanchnic blood volume was calculated by dividing the amount of IHSA activity dispersed in the splanchnic vasculature at equilibrium by the equilibrium concentration as follows: (11,12), the portal vein, and femoral artery, before and after administration of hexamethonium (0.6 to 0.8 mg. ion per Kg.). Portal venous pressures were measured by means of a polyethylene catheter passed after laparotomy through one of the splenic vein radicles approximately 10 cm.…”

Porto-Caval and Porto-Pulmonary Anastomoses in Laennec's Cirrhosis and in Heart Failure1

“…Increased right atrial and caval pressure in right heart failure is accompanied by an increase in portal venous pressure to or slightly above the level of right atrial pressure (29,30). Thus it is not surprising that collateral channels between the portal and caval systems may be dilated.…”

Associação entre gradiente de pressão portal e ascite em pacientes com cirrose

“…Nesse método, o ponto de referência é a pressão venosa hepática livre, medida na junção da veia hepática e/ ou na veia cava inferior. A medida da pressão venosa hepática ocluída e livre fornece gradiente entre essas duas pressões, o gradiente de pressão venosa hepática (GPVH), que é um método indireto, simples e seguro para a avaliação da pressão portal, que vem sendo utilizado há mais de 50 anos (2,4,14,16,15,31) . Em indivíduos normais, o gradiente entre a pressão venosa hepática ocluída e livre varia de 1 até 4 ou 5 mm Hg.…”