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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/12829

Title: Prospective Study Comparing Different Indirect Methods to Measure Portal Pressure
Authors: Maleux, Geert
Willems, Endry
FIEUWS, Steffen
Heye, Sam
Vaninbroukx, Johan
Laleman, Wim
Cassiman, David
Verslype, Chris
Nevens, Frederik
Issue Date: 2011
Abstract: Purpose: To compare the accuracy of wedged hepatic venous pressure (WHVP) measurement with use of an end-hole catheter or an occlusion-balloon catheter versus direct portal pressure (PP) measurement in patients with cirrhosis with sinusoidal portal hypertension and to investigate the factors that affect the results of these indirect measurements. Materials and Methods: In a cohort of 174 patients with cirrhosis referred for transjugular intrahepatic portosystemic shunt creation, indirect PP was measured with an end-hole catheter and an occlusion-balloon catheter placed in the right hepatic vein. Direct PP was measured by a pigtail catheter in the main branch of the portal vein. Results: PP was more accurately estimated by the occlusion-balloon technique: mean WHVP measurements were 25.5 mm Hg +/- 7.9 and 30.6 mm Hg +/- 13.9, respectively, for the occlusion-balloon and end-hole catheter techniques, and the direct PP measurement was 25.0 mm Hg +/- 7.0. The median absolute differences between direct and the indirect methods were 6.0 mm Hg with the end-hole catheter and 2.0 mm Hg with the occlusion-balloon catheter (P < .0001, signed-rank test). Relative to direct PP measurements, the occlusion-balloon technique overestimated pressures in cases of higher Model for End-Stage Liver Disease (MELD) scores (Spearman rho = -0.24; P = .0005). Conclusions: Compared with direct PP measurements, agreement was clearly higher for indirect WHVP measurement with occlusion-balloon catheters versus end-hole catheters. However, in patients with a high MELD score, there was an overestimation of PP with the occlusion-balloon method.
Notes: [Maleux, G; Willems, E; Heye, S; Vaninbroukx, J] Katholieke Univ Leuven Hosp, Dept Radiol, B-3000 Louvain, Belgium. [Laleman, W; Cassiman, D; Verslype, C; Nevens, F] Katholieke Univ Leuven Hosp, Dept Hepatol, B-3000 Louvain, Belgium. [Fieuws, S] Katholieke Univ Leuven, Interuniv Inst Biostat & Stat Bioinformat, Louvain, Belgium. Univ Hasselt, Louvain, Belgium. geert.maleux@uzleuven.be
URI: http://hdl.handle.net/1942/12829
DOI: 10.1016/j.jvir.2011.08.003
ISI #: 000296661800010
ISSN: 1051-0443
Category: A1
Type: Journal Contribution
Validation: ecoom, 2012
Appears in Collections: Research publications

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