| Hepatic perfusion before and after the transjugular intrahepatic portosystemic shunt procedure: impact on survival. | |
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MedLine Citation:
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PMID: 10928532 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: This study correlates transjugular intrahepatic portosystemic shunt (TIPS) mortality with flow patterns in the cirrhotic liver. MATERIALS AND METHODS: Twenty-seven TIPS patients and 10 control subjects were used for this study. The authors evaluated hepatic perfusion with venous injections of Tc-99m pertechnetate before and after TIPS. Hepatic time-activity curves were analyzed for type and amount of liver perfusion. These parameters were correlated with survival for a mean follow-up of 18 months. RESULTS: The mean arterial contribution to liver blood flow was 25.4% in the normal control patients, 39.9% in patients prior to TIPS, and increased to 48.3% after TIPS. Although the proportion of arterial supply to the cirrhotic liver varied widely, TIPS mortality did not correlate with the preprocedure hepatic artery/portal venous perfusion ratio. However, patients with both an "arterialized" flow pattern and low total hepatic perfusion had higher mortality, with a mean survival of 2 months compared to patients with a more favorable perfusion profile (mean survival, 28.4 months). CONCLUSIONS: The proportion of arterial perfusion to the liver before TIPS did not affect survival. However, patients with a combination of reduced total hepatic perfusion and an arterial flow pattern had poorer survival, suggesting that both the quantity and quality of hepatic perfusion predicts TIPS outcome. |
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Authors:
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E M Walser; R DeLa Pena; J Villanueva-Meyer; O Ozkan; R Soloway |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of vascular and interventional radiology : JVIR Volume: 11 ISSN: 1051-0443 ISO Abbreviation: J Vasc Interv Radiol Publication Date: 2000 Jul-Aug |
Date Detail:
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Created Date: 2000-11-15 Completed Date: 2000-11-30 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9203369 Medline TA: J Vasc Interv Radiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 913-8 Citation Subset: IM |
Affiliation:
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Department of Radiology, University of Texas Medical Branch, Galveston 77555-0709, USA. emwalser@utmb.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Follow-Up Studies Forecasting Hepatic Artery / physiopathology Humans Liver / radionuclide imaging Liver Circulation / physiology* Liver Cirrhosis / physiopathology*, radionuclide imaging, surgery Portal Vein / physiopathology Portasystemic Shunt, Transjugular Intrahepatic* Radiology, Interventional Radiopharmaceuticals / diagnostic use Regional Blood Flow / physiology Regression Analysis Renal Circulation / physiology Sodium Pertechnetate Tc 99m / diagnostic use Spleen / blood supply Survival Rate Time Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 23288-60-0/Sodium Pertechnetate Tc 99m |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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