OBJECTIVE: This study was undertaken to determine the effects of transjugular intrahepatic portasystemic shunt (TIPS) and small-diameter prosthetic H-graft portacaval shunt (HGPCS) on portal and effective hepatic blood flow. SUMMARY BACKGROUND DATA: Mortality after TIPS is higher than after HGPCS for bleeding varices. This higher mortality is because of hepatic ...

Systemic and hepatic hemodynamics were prospectively studied in 11 patients with Manson's schistosomiasis and portal hypertension, as well as alterations resulting from the use of propranolol. It was decided that patients whose portal pressure was reduced by 30% with the use of the drug would not undergo surgery and that ...

Hepatopulmonary syndrome (HPS) causes impaired oxygenation due to intrapulmonary vasodilatation in patients with cirrhosis. Chronic common bile duct ligation (CBDL) in the rat results in gas-exchange abnormalities similar to HPS, but intrapulmonary vasodilatation has not been evaluated. We assess intrapulmonary vasodilatation, measured in vivo, after CBDL. Sham, 2- and 5-wk ...

The purpose of the present study was to determine whether selective blockade of adenosine 3',5'-cyclic monophosphate (cAMP)- or guanosine 3',5'-cyclic monophosphate (cGMP)-mediated events modulated norepinephrine responses in intestinal microvessels of normal and portal hypertensive rats. Vascular norepinephrine responses were evaluated before and after inhibition of cAMP-dependent protein kinase [protein kinase ...

BACKGROUND: In chronic pancreatitis, compression of the splenic vein and superior mesenteric vein (SMV) by an inflammatory mass may cause segmental portal hypertension. Drainage and resection are the principles of surgery for chronic pancreatitis. This study was devised to evaluate the effect of drainage and resection on venous splanchnic blood ...

PURPOSE: To describe the intrinsic sampling variability of measurements of portal venous flow in healthy volunteers and to estimate the variability attributable to the sonographer, the subject, and the measurement. MATERIALS AND METHODS: In a randomized controlled fashion, nine sonographers measured portal venous flow in five subjects. Each sonographer measured ...

A nocturnal increase in portal pressure and blood flow was demonstrated in patients with cirrhosis, suggesting that these hemodynamic changes may contribute to the triggering of the hemorrhagic episodes observed during the night in these patients. It is known that propranolol reduces portal flow, thus reducing the risk of variceal ...

BACKGROUND/AIMS: Beta-blockers are currently used for chronic therapy of portal hypertension. Duplex Doppler ultrasonography has been proposed for non-invasive evaluation of splanchnic pharmacodynamics, but the chronic effects of beta-blockers on portal hemodynamics and on splanchnic arterial impedance indices have not been analyzed with this method. This was the aim of ...

BACKGROUND/AIMS: The aim was to study the reproducibility of magnetic resonance velocity mapping, when measuring portal vein and superior mesenteric artery blood flow, under fasting and post-prandial conditions. Magnetic resonance flow measurements for the portal vein were compared with echo-Doppler measurements in the right portal vein. METHODS: Eight healthy volunteers ...

Portal thrombosis may complicate the clinical course of cirrhosis, but the pathophysiologic mechanism is unclear. Aim of the study was to evaluate the behavior of clotting system and endotoxemia in portal vein and in peripheral circulation of 11 cirrhotic patients undergoing transjugular port-systemic shunt (TIPS). Portal blood showed higher values ...

BACKGROUND: Partial portal decompression, as attained by small-diameter prosthetic H-graft portacaval shunting, continues to gain popularity because of favorable outcomes. This study was undertaken to determine whether the direction of preshunt or postshunt portal blood flow or reversal in the direction of portal flow occurred with shunting effect outcome after ...

The response of the systemic, pulmonary, hepatic and portal circulations to infusion of dopamine and epinephrine was studied in newborn piglets 1 to 3 d of age. Anesthetized animals were instrumented to measure cardiac index (CI), hepatic arterial flow, and portal venous blood flow. Catheters were inserted for measurement of ...

BACKGROUND: Duplex ultrasonography has become the optimal non-invasive method of assessing the deep venous system of the leg. The stimuli used to promote reverse flow, subject positioning, and the veins scanned have varied between studies. Reverse flow of less than 0.5 s is accepted as 'normal', however, all published studies ...

Nitric oxide (NO) and leukotrienes are potent vasoactive agents that are involved in the control of portal blood flow. The present study investigated the role of leukotriene D4 and NO in a non-recirculating constant pressure rat liver perfusion model to analyse their interchanges on portal flow and bile secretion. The ...

The prognostic significance of carcinoembryonic antigen (CEA) values in the drainage vein of the tumor (portal blood levels of CEA) of colorectal cancer patients were evaluated by examining the correlation with the peripheral blood levels of CEA and histopathologic findings of the tumor. 1) Portal blood levels of CEA were ...

PURPOSE: To investigate the effect of a meal on splanchnic circulation in patients with cirrhosis of the liver. MATERIALS AND METHODS: Ten adult patients with cirrhosis and 10 adult control subjects (mean age, 54 years) underwent duplex ultrasonography. Flow volumes of the portal vein, superior mesenteric artery, splenic artery, and ...

Intestinal ischemia-reperfusion (I/R) causes a myriad of systemic physiologic derangements including pulmonary neutrophil (PMN) sequestration, increased microvascular permeability, and adult respiratory distress syndrome. It has been suggested that the observed lung injury is mediated by transhepatic passage of portal venous blood from ischemic intestine resulting in hepatic Kupffer cell activation ...

AIMS: Splenomegaly is common in portal hypertension due to hepatic cirrhosis, but there are little data comparing different methods of spleen measurement. We have compared ultrasound with radionuclide imaging in measuring splenomegaly. The relation of splenomegaly to hypersplenism and portal hemodynamic factors was also studied. RESULTS: Ultrasound and radionuclide measures ...

Direct measurement of portal venous blood flow is technically difficult, yet crucial for accurate assessment of liver hemodynamic and metabolic functions. The aim of this investigation was to assess the feasibility of implanting transit-time ultra-sound (TTUS) perivascular flow probes on the portal vein of the rat and to validate this ...

Flow volume in the azygos venous system was quantitated with Cine-phase contrast (PC) velocity mapping in volunteers and compared with patients with known portal hypertension, who were referred for transjugular intrahepatic portosystemic shunt (TIPS) placement. Subsequently, the TIPS-induced hemodynamic effects on portal and azygos flow were analyzed. To assess intra- ...

RATIONALE AND OBJECTIVES: We evaluated liver vascular physiology with a functional spiral computed tomography (CT) technique and an intravascular contrast agent. METHODS: Eleven rabbits were studied by means of continuous 40-second single-section data acquisition after bolus injection of an experimental contrast agent. Sequential images were reconstructed at 200-msec intervals. Aortic, ...

Obstructive jaundice was produced in adult mongrel dogs by cholecystectomy and ligation of the common bile duct. Two weeks later 40% hepatectomy was performed during 10 min occlusion of hepatic inflow (group I). Liver tissue lipid peroxide levels increased significantly and superoxide dismutase activity decreased. The portal endotoxin (Et) concentration ...

BACKGROUND & AIMS: In portal-hypertensive humans, portal blood flow and pressure increase after a meal. These hemodynamic changes may increase variceal rupture risk. The aim of this study was to determine whether blood in the stomach lumen increases splanchnic flow and portal pressure (PP) in portal-hypertensive rats. METHODS: superior mesenteric ...

We examined 29 patients with intra- and extrahepatic masses and 10 normal volunteers with duplex and color Doppler ultrasonography. Portal blood flow adjacent to the masses was categorized as anterograde, retrograde, or nondetectable and was correlated with lesion size, character, and location. Anterograde flow was documented in the main portal ...

BACKGROUND/AIMS: Vasopressin reduces portal pressure which may be due to decreased portal inflow. However, it remains unclear whether vasopressin is able to selectively reduce esophageal varices blood flow. The aim of this study was to address this question. METHODS: Fifteen patients with cirrhosis and esophageal varices were included in this ...

PURPOSE: To evaluate the accuracy of Doppler ultrasonography (US) in determination of patency and detection of stenosis in transjugular intrahepatic portosystemic shunts (TIPS). MATERIALS AND METHODS: Retrospective review was performed of 251 Doppler sonograms obtained in 79 patients who underwent TIPS placement. Sonograms were evaluated for (a) the presence of ...

Echo-Doppler measurements of portal venous blood flow in intrahepatic branches and indocyanine green (ICG) clearance after continuous i.v. infusion as measure for liver blood flow were compared to evaluate the increase in splanchnic blood flow after food intake. It was shown that both methods assessed the changes in flow in ...

BACKGROUND/AIMS: The present study was aimed to evaluate the 24-hour effect of transdermal nitroglycerin on splanchnic hemodynamics in cirrhotic patients. METHODS: Hemodynamic parameters (blood velocity and resistance indexes) were determined by means of pulsed echo-Doppler, a non-invasive method which proved to be useful to evaluate the effects of drugs on ...

Portal hypertension results from increases in portal flow and portal vascular resistance. Factors increasing portal blood flow are predominantly humoral. Resistance to portal flow has a fixed component due to distortion of the vasculature by cirrhotic nodules and a variable component that is related to vasoactive substances. Varices result from ...

PURPOSE: To assess the effect of verapamil (80 mg) oral administration on portal and splanchnic hemodynamics in patients with advanced posthepatitic cirrhosis using duplex Doppler ultrasound (US). METHODS: Fourteen patients with post-hepatitic liver cirrhosis were included in the study. Duplex Doppler sonographic examinations were performed before, and 2-3 h after, ...

The present study was designed to determine the systemic haemodynamic effects of obliterating oesophageal varices by endoscopic sclerotherapy. We evaluated systemic and splanchnic haemodynamics before and after the first course of sclerotherapy in cirrhotic patients. The baseline cardiac index was significantly correlated with baseline azygos vein blood flow (r = ...

Patients with cirrhosis of the liver have increased hepatic and gastrointestinal lymph flow that may contribute to the formation of ascites and pleural effusions. Increased lymph flow, which is due to postsinusoidal portal hypertension, causes a high rate of flow through the thoracic duct. Because of the high flow rates, ...

Color Doppler sonography was used to investigate the changes in intrahepatic portal hemodynamics in early stage hepatic abscesses (21 lesions). At time of patients' admission, 10 lesions measuring over 6 cm showed reverse flow from at least one of their corresponding segmental portal branches, but 11 lesions measuring 6 cm ...

PURPOSE: The local absorption kinetics of levofloxacin from the intestinal tract was quantitatively evaluated by simultaneously measuring the portal and venous plasma concentrations in a conscious rat. METHODS: The venous and upper portal blood vessels were cannulated through the jugular and pyloric veins, respectively. After oral or intravenous administration of ...

The effects of endoscopic variceal ligation (EVL) on systemic hemodynamics are unknown. This study was conducted to determine whether the obliteration of portal-systemic collaterals by EVL affects systemic hemodynamics and serum nitrate concentrations in patients with compensated cirrhosis. We measured systemic and hepatic hemodynamics, azygos vein blood flow (AzBF), and ...

BACKGROUND/AIMS: It has been suggested that mechanical pumping of portal blood to the liver may correct portal hypertension while increasing portal flow to the liver, which may enhance liver function in cirrhosis. However, the hemodynamic effects of this procedure are unknown. The present study investigated these issues in rats with ...

BACKGROUND/AIMS: Long-term administration of spironolactone is reported to reduce portal pressure in cirrhotic patients. We examined the effects of acute administration of canrenoate potassium, an aldosterone antagonist, on portal hemodynamics in compensated cirrhotic patients using noninvasive duplex Doppler ultrasonography. MATERIALS AND METHODS: Baseline values were obtained in the fasting state, ...

OBJECTIVE: The variability of consecutive cine phase-contrast MR flow measurements could significantly affect their use for clinical decisions, especially during provocative testing. The purposes of this study were to determine the normal variability of flow and consecutive flow measurements in the main portal vein on MR images and to determine ...

The present study investigates whether the application of the summation of portal blood flow (SPBF), measured from the left umbilical portion and the right anterior branch by Doppler, could be of use in the longitudinal study of intrahepatic portal flow or not. Forty-five subjects were divided into two groups. Group ...

Twenty-four cats with clinical and, or, clinicopathological signs compatible with portosystemic shunting were examined prospectively using two-dimensional grey-scale, duplex and colour-flow Doppler ultrasonography. Diagnosis of congenital portosystemic shunt was subsequently confirmed in 14 cats using operative mesenteric portography and surgery. Of the 14 affected cats, nine were purebred; eight were ...

BACKGROUND/AIMS: This is a report of a study designed to confirm the presence and determine the effectiveness of portacaval shunts. MATERIAL AND METHODS: Color Doppler ultrasonography of the portal system, as a superior diagnostic procedure, was performed in experimental animals. RESULTS: Presence of shunt is indicated by initial loss of ...

A previously validated physiologically based pharmacokinetic model was used to examine whether epoprostenol-induced increases in gastrointestinal blood flow (Qg) could alter digoxin systemic bioavailability to a clinically significant extent in severe congestive heart failure (CHF) patients. A series of simulations was conducted in which the influences of apparent gut tissue-to-plasma ...

The sinusoidal structure and blood supply of 38 liver nodules less than 2 cm in diameter were investigated. There were 18 cases of adenomatous hyperplasia (AH) and 20 cases of hepatocellular carcinoma (HCC). Growth pattern, encapsulation and vascularity were examined, and immunohistochemistry performed for factor VIII related antigen (factor VIII), ...

Vasopressin (Pitressin, 8-arginine vasopressin) is a potent vasoconstrictor of splanchnic arterioles. When administered by continuous intravenous infusion, it reduces portal blood flow and pressure and is used in the management of bleeding esophageal varices. We describe a purpuric and necrotic cutaneous reaction to vasopressin that occurred at locations distant from ...

BACKGROUND & AIMS: Nitric oxide, which is quenched by hemoglobin, has been implicated in the pathogenesis of portal hypertension. The aim of this study was to investigate the effects of increasing blood hemoglobin concentration by erythropoietin treatment on the gastrointestinal vasodilation associated with portal hypertension. METHODS: Portal-hypertensive and sham-operated rats ...

OBJECTIVE: To surgically create complete portacaval shunts in dogs during temporary arrest of intestinal arterial and portal venous blood flow. DESIGN: Complete portacaval anastomoses were surgically created, and liver function was evaluated for 14 to 18 weeks after surgery. ANIMALS: 32 adult mixed-breed dogs of either sex. PROCEDURE: Administration of ...

OBJECTIVE: The author's evaluated the clinical significance of the development of reversed portal flow after abdominal surgery other than portosystemic shunt procedure. SUMMARY BACKGROUND DATA: There have been several reports in regard to reversed portal flow demonstrated by pulsed Doppler ultrasonography, most of which were related to portal hypertension. To ...

The responses of the portal and hepatic arterial blood flows to various diets and nutrients were measured simultaneously in conscious dogs prior to and following hepatic resection. Prior to hepatectomy, the increase in the portal blood flow was significantly larger in response to an elemental diet, fats, or amino acids ...

OBJECTIVES: Portal hypertension may develop in patients with severe acute hepatitis. Sequential changes of portal venous hemodynamics in acute hepatitis is not well understood. This study evaluated portal hemodynamic changes and prognostic values in patients with severe, acute hepatitis. METHODS: Doppler studies, liver function tests, and virology studies were done ...

PURPOSE: To quantify portosystemic shunting and hepatic portal perfusion after placement of a transjugular intrahepatic portosystemic shunt (TIPS). MATERIALS AND METHODS: Technetium-99m macroaggregated albumin (MAA) was injected directly into the portal veins of nine asymptomatic patients 3 months after TIPS placement. Portosystemic shunting was quantified by comparing counts in the ...