Wedged and free hepatic venous pressure measured with a balloon catheter

Hemodynamic Studies in Acute-on-Chronic Liver Failure

“…Under local anesthesia, a central venous catheter (7F, Arrow; Arrow International, Reading, PA) was placed in the right femoral vein or internal jugular vein under fluoroscopic guidance by using the Seldinger technique. The HVPG was measured by the standard technique [15] in which a balloon catheter (Swan-Ganz) was introduced into the right hepatic vein under fluoroscopic control. The zero reference point was set as the atmospheric pressure at the mid-axillary point.…”

Duplex Doppler Ultrasound Examination of the Portal Venous System: An Emerging Novel Technique for the Estimation of Portal Vein Pressure

“…However, in patients with cirrhosis, sinusoidal pressure accurately reflects the actual portal pressure [17]. A balloon catheter is most commonly used to occlude the hepatic vein [18]. Inflating the balloon provides pressure recording from a wider area of the liver parenchyma and more closely represents the true portal pressure [15].…”

Wedged Hepatic Venous Pressure Does Not Reflect Portal Pressure in Patients with Cirrhosis and Hepatic Veno–Venous Communications

“…Its advantage compared with direct PVP measurement is that it is easy, safe, and less invasive. The WHVP has been reported to be equal to the PVP in animal experiments and in alcoholic cirrhosis [6][7][8]22]. However, in non-alcoholic patients, such as those with primary biliary cirrhosis, non-cirrhotic idiopathic portal hypertension, chronic active hepatitis, and non-alcoholic cirrhosis, WHVP has been thought to underestimate PVP [7,8,11].…”

“…WHVP was measured by occlusion of the hepatic vein with the balloon inflated with 1-2 mL air. Adequate occlusion of the hepatic vein was confirmed by the absence of reflux after manual injection of a small amount (2-3 mL) of contrast medium [6]. Free hepatic venous pressure (FHVP) measurement was obtained with the balloon deflated.…”

“…It is well established that wedged hepatic venous pressure (WHVP) is equal to portal vein pressure (PVP) in cirrhotic dogs [6] and in patients with alcoholic liver cirrhosis [7,8], but it is still controversial in patients with non-alcoholic cirrhosis [7,8].…”