Lai Lawrence, Poneros John, Santilli John, Brugge William
Caritas Medical Center Hong Kong, Brigham and Women's Hospital, Vascular Radiology and GI Unit, Massachusetts General Hospital, Boston 02114, USA.
Gastrointest Endosc. 2004 Feb;59(2):280-3. doi: 10.1016/s0016-5107(03)02544-6.
The extrahepatic portal vein is inaccessible to direct catheterization.
Because EUS can readily image the portal vein, the feasibility of EUS-guided portal vein catheterization by using a 22-gauge needle was studied in 7 normal pigs and 14 pigs in which portal hypertension was induced (7/14 anticoagulated).
Catheterization was not possible by EUS or transhepatic methods in, respectively, 3 and 5 animals. One anticoagulated animal had a small amount of periduodenal bleeding as a result of EUS catheterization. The mean normal portal vein pressure (1 standard deviation) as determined by EUS and transhepatic methods was, respectively, 20.3 (4) mm Hg and 20.4 (2) mm Hg. Injection of polyvinyl alcohol particles increased the portal vein pressure by 10.2 (11.59) mm Hg. There was a close correlation under all conditions between the mean portal vein pressures obtained by EUS and transhepatic catheterization (r=0.91).
EUS-guided portal vein catheterization appears to be feasible in an animal model and provides accurate pressure measurements.
肝外门静脉无法直接进行导管插入术。
由于超声内镜(EUS)能够轻易对门静脉成像,因此在7只正常猪和14只诱导门静脉高压的猪(7/14进行抗凝)中研究了使用22号针进行EUS引导的门静脉导管插入术的可行性。
分别有3只和5只动物无法通过EUS或经肝方法进行导管插入术。1只抗凝动物因EUS导管插入术出现少量十二指肠周围出血。通过EUS和经肝方法测定的平均正常门静脉压力(1个标准差)分别为20.3(4)毫米汞柱和20.4(2)毫米汞柱。注射聚乙烯醇颗粒使门静脉压力升高了10.2(11.59)毫米汞柱。在所有情况下,EUS和经肝导管插入术获得的平均门静脉压力之间存在密切相关性(r = 0.91)。
EUS引导的门静脉导管插入术在动物模型中似乎是可行的,并能提供准确的压力测量。