EUS-guided portal vein catheterization: a promising novel approach for portal angiography and portal vein pressure measurements.
BACKGROUND
Portal vein (PV) pressure measurements can provide valuable information for the management of patients with liver disease and portal hypertension.


OBJECTIVE
To evaluate the feasibility and the safety of EUS-guided PV catheterization and pressure measurements in a porcine model.


METHODS
Acute and survival experiments on five 50-kg pigs.


METHODS
Intrahepatic PV was punctured under EUS guidance by using a 19-gauge FNA needle. A 0.035-inch guidewire was advanced through the needle into the PV. The needle was withdrawn. A 5.5F ERCP catheter was advanced over the guidewire into the PV and then connected to a pressure monitor. Continuous PV measurements were obtained for an hour. Afterward, the catheter was removed, and the animals were observed for 30 minutes. Three animals were then immediately euthanized for a necropsy. The other two animals were observed for two weeks and then were euthanized.


METHODS
The ability to perform EUS-guided PV catheterization and pressure measurement without complications.


RESULTS
PV catheterization, angiography, and pressure measurements were performed without any problems or complications. There were no changes in vital signs and hemodynamic parameters during PV catheterizations, angiography, pressure measurements, and catheter removal. Survival experiments did not demonstrate any change in animal condition, behavior, or eating habits after the procedure. A necropsy in all animals revealed no active bleeding, and no damage to the liver, other intra-abdominal organs, or blood vessels.


CONCLUSIONS
No validation of measured PV pressure was made.


CONCLUSIONS
EUS-guided PV catheterization is feasible, safe, and can be used for portal angiography and pressure measurements.
Giday
Samuel A
SA
Division of Gastroenterology, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland 21205, USA.
Clarke
John O
JO
Buscaglia
Jonathan M
JM
Shin
Eun J
EJ
Ko
Chung-Wang
CW
Magno
Priscilla
P
Kantsevoy
Sergey V
SV
D000792:Angiography / Q000379:methods; D000818:Animals; D044963:Biopsy, Fine-Needle / Q000295:instrumentation; D019160:Endosonography / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006975:Hypertension, Portal / Q000175:diagnosis*; D023421:Models, Animal; D011169:Portal Vein / Q000000981:diagnostic imaging; D011677:Punctures; D013552:Swine; D018084:Ultrasonography, Interventional / Q000379:methods*