| Institution: | 1. Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China;2. Shanghai Institution of Medical Imaging, Shanghai, China;3. Department of General Surgery, Shanghai Pudong New Area People’s Hospital, Shanghai, China;1. Interventional Radiology Unit, Department of Medical Imaging, University Hospital Heraklion, University of Crete Medical School, Voutes, 71110 Heraklion, Greece;2. Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University Hospital Heraklion, University of Crete Medical School, Voutes, 71110 Heraklion, Greece;3. Department of Medical Oncology, University Hospital Heraklion, University of Crete Medical School, Voutes, 71110 Heraklion, Greece;1. Department of Diagnostic and Interventional Radiology, RWTH Aachen University Hospital, Aachen, Germany;2. Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany;3. Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan;1. Section of Interventional Radiology, Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania;2. Division of Vascular Surgery, Department of Surgery, Penn Presbyterian Medical Center, University of Pennsylvania, Philadelphia, Pennsylvania;1. Department of Radiology, Ludwig-Maximilians University, Munich, Germany;2. Pathological Institute, Ludwig-Maximilians University, Munich, Germany;3. Evidensia Veterinary Clinic for Small Animals GmbH Norderstedt, Norderstedt, Germany;4. Research and Development Laboratory, microParticles GmbH, Berlin, Germany;5. Department of Radiology, Charité, Humboldt University Medical School, Berlin, Germany;1. Liver Unit, Hospital Vall Hebron, Barcelona, Spain;2. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain;3. Departament Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain |
| Abstract: | PurposeTo quantitatively analyze the impact of intrahepatic venovenous shunt (IHVS) on hepatic venous pressure gradient (HVPG) measurement.Materials and MethodsFrom 2015 to 2019, 222 HVPG measurements performed during transjugular intrahepatic portosystemic shunt creation were eligible for this study. Digital subtraction angiography (DSA) software color-coded each pixel of a two-dimensional DSA series by time-intensity curve to classify IHVS. Different degrees of IHVS were found in 36.5% of patients (81/222). Mild IHVS was found in 10.8% of patients (24/222), moderate IHVS was found in 10.8% of patients (24/222), and severe IVHS was found in 14.9% of patients (33/222).ResultsMean wedged hepatic vein pressure (WHVP) and HVPG were significantly lower in patients with IHVS compared with patients without IHVS (WHVP: 17.78 mm Hg ± 7.00 vs 24.89 mm Hg ± 8.69, P = .001; HVPG: 11.93 mm Hg ± 5.76 vs 18.6 mm Hg ± 6.85, P < .001). Mild IHVS had little effect on WHVP and HVPG. Mean WHVP and HVPG were 11 mm Hg lower in patients with moderate IHVS (WHVP: 20.38 mm Hg ± 8.38 vs 31.5 mm Hg ± 9.39, P = .026; HVPG: 13.88 mm Hg ± 6.33 vs 25.00 mm Hg ± 9.81, P < .001) and 15 mm Hg lower in patients with severe IHVS (WHVP: 13.45 mm Hg ± 5.28 vs 28.64 mm Hg ± 6.38, P = .017; HVPG: 8.27 mm Hg ± 3.85 vs 23.45 mm Hg ± 6.95, P < .001) than mean portal vein pressure and portal vein gradient.ConclusionsFor patients with moderate or severe IHVS, HVPG might greatly underestimate the actual value of portal vein pressure, and the portal vein should be catheterized to measure portal pressure. |
