Balloon occlusion superior mesenteric arteriography for improved venous opacification: a clinical trial.

Balloon occlusion superior mesenteric arteriography and nonocclusion superior mesenteric arteriography were compared prospectively and retrospectively for adequacy of mesenteric and portal venous visualization. Prospective, occlusion studies in 20 patients were uniformly judged of excellent visual quality, while retrospectively, only 30% of nonocclusion studies from 20 other patients were considered optimal. In 10 of the patients who had balloon occlusion superior mesenteric arteriography, the procedure was preceded by a control nonocclusion superior mesenteric arteriography study. In only two (20%) patients was the nonocclusion study rated of excellent visual quality. Each study was assessed a rating of 0-3, according to how well the mesenteric and portal venous system visualized. Prospectively, all 20 balloon occlusion superior mesenteric arteriography studies were given the highest obtainable rating (3). Retrospectively, only six (30%) 20 nonocclusion superior mesenteric arteriography studies received a rating of 3; hence, 14 (70%) of the nonocclusion studies were rated less than excellent in visual quality when looked at retrospectively. No complications occurred with balloon occlusion superior mesenteric arteriography, and the occlusion procedure consistently gave excellent visualization of the mesenteric and portal venous anatomy.