Applicability of prostaglandin E1 indirect portal vein angiography in patients with portal hypertension | JoVE Visualize

Applicability of prostaglandin E1 indirect portal vein angiography in patients with portal hypertension

Z Peng¹, Z Dai, S Qiao

¹Department of Surgery, Tongji Hospital, Tongji Medical University, Wuhan.

Chinese Medical Journal|May 1, 1995

View abstract on PubMed

Summary

Prostaglandin E1 (PGE1) indirect digital subtraction angiography (DSA) significantly improves portal vein imaging. This technique aids in diagnosing portal hypertension complications and guiding treatment decisions for digestive tract hemorrhage.

Area of Science:

Interventional Radiology
Vascular Imaging
Gastroenterology

Background:

Portal hypertension is a serious condition often leading to digestive tract hemorrhage.
Accurate visualization of the portal venous system is crucial for diagnosis and treatment planning.
Traditional imaging methods may have limitations in visualizing specific venous structures.

Purpose of the Study:

To evaluate the effectiveness of prostaglandin E1 (PGE1) indirect portal vein digital subtraction angiography (DSA) in improving portal vein imaging quality.
To assess the visualization rates of key gastric and splenic veins using this technique.
To determine the diagnostic and therapeutic implications of PGE1 indirect portal vein DSA findings in patients with portal hypertension and digestive hemorrhage.

Main Methods:

A retrospective analysis of 23 cases utilizing PGE1 indirect portal vein DSA.
Assessment of imaging quality improvements.
Calculation of visualization rates for splenic vein (SV), left gastric vein (LGV), and short gastric vein (SGV).
Analysis of time-density curves to evaluate blood flow patterns.

Main Results:

PGE1 indirect portal vein DSA significantly enhanced imaging quality.
The highest occurrence rate of opposite hepatic blood flow was observed in the splenic vein (17.4%).
Visualization rates were 78.3% for LGV and 36.4% for SGV.
Angiography via superior mesenteric artery and splenic artery demonstrated equal importance.

Conclusions:

PGE1 indirect portal vein DSA is a valuable tool for improving portal vein imaging in portal hypertension patients.
Failure to visualize LGV and SGV may suggest non-variceal bleeding sources.
Dilation in LGV and SGV with opposite hepatic blood flow supports considering devascularization procedures.