title: Portal and splanchnic hemodynamics after partial splenic embolization in cirrhotic patients with hypersplenism.
abstract: To assess the acute effects of partial splenic embolization (PSE) on portal and splanchnic hemodynamics in patients with cirrhosis. Ninety-five patients with hypersplenism were included in the study. Duplex examinations were performed before and 3 and 7 days after PSE. Portal and splanchnic hemodynamics including vessel cross-sectional area (CSA), mean flow velocities (cm/s), blood flows (mL/min), Doppler indices as portal congestion index (CI), liver vascular index, hepatic artery and superior mesenteric artery (SMA) pulsatility and resistive indices (PI and RI), were performed before and after PSE. In our study, 69 of 95 patients were males (72.6%) and 26 females (27.3%). Chronic hepatitis C virus infection was the main cause of cirrhosis (81.1%). PSE failed technically in six patients (6.3%). After PSE, both CSA and CI significantly decreased (p < 0.05 and <0.01). The portal vein velocity significantly increased (p < 0.01). The portal flow volume (892.4 ± 151 mL/min) did not show significant changes. The hepatic artery RI and PI showed a steady increase that became significant 7 days post-PSE (p < 0.05). The RI and PI of SMA increased significantly after 7 days of PSE (p < 0.05). PSE has an immediate portal decompression effect in patients with portal hypertension without reduction in portal flow. This effect on portal pressure should be investigated in future studies as a potential tool for management of acute variceal bleeding when other medical procedures fail.
authors.affiliation: Internal Medicine Department, Alexandria Faculty of Medicine, Alexandria, Egypt.
authors.forename: Ahmed Z
authors.initials: AZ
authors.lastname: Helaly
authors.affiliation: Department of Radiology, National Liver Institute, Menoufiya University, Shebeen El kom, Egypt.
authors.forename: Mohamed S
authors.initials: MS
authors.lastname: Al-Warraky
authors.affiliation: Department of Hepatology, National Liver Institute, Menoufiya University, Shebeen El kom, Egypt.
authors.forename: Gasser I
authors.initials: GI
authors.lastname: El-Azab
authors.affiliation: Department of Hepatology, National Liver Institute, Menoufiya University, Shebeen El kom, Egypt.
authors.forename: Mohamed A S
authors.initials: MA
authors.lastname: Kohla
authors.affiliation: Department of Hepatology, National Liver Institute, Menoufiya University, Shebeen El kom, Egypt.
authors.forename: Elsayed E
authors.initials: EE
authors.lastname: Abdelaal
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D004621:Embolization, Therapeutic; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006499:Hepatic Artery / Q000503:physiopathology; D019698:Hepatitis C, Chronic / Q000209:etiology; D006801:Humans; D006971:Hypersplenism / Q000209:etiology / Q000503:physiopathology*; D008099:Liver / Q000098:blood supply* / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D017538:Mesenteric Artery, Superior / Q000503:physiopathology; D008875:Middle Aged; D011168:Portal System / Q000503:physiopathology; D011169:Portal Vein / Q000503:physiopathology; D013152:Splanchnic Circulation / Q000502:physiology*; D055815:Young Adult
keywords: Portal; hemodynamics; hypersplenism; splenic embolization