Hepatic Vein Catheterization

  • Didier Lebrec


Hepatic vein catheterization is a simple and safe technique allowing diagnostic and therapeutic investigations in portal hypertension. The diagnostic studies consist of hemodynamic measurements including pressure and blood flow, and hepatic- or portoangiographies. The therapeutic investigations are used either to treat acute variceal bleeding by obliterating these vessels or to prevent rebleeding by creating portohepatic shunts. At present, diagnostic investigations are widely used. Other non-hepatic hemodynamic values such as azygos blood flow and cardiac output can be measured during this procedure. Therapeutic procedures are not yet currently used. In this chapter, all the methods which involve hepatic vein catheterization are reported. During these investigations, transvenous liver biopsy and cholangiography can also be performed [1]. This type of biopsy, essential in hepatology and thus in portal hypertension, is also described in detail since the technique is very similar for all hepatic vein investigations. Cholangiography is not described, however, since it is not used to investigate portal hypertension. For the same reason, although hepatic vein catheterization may be useful for the calculation of drug extraction, this area is not discussed in this chapter. Finally, it must be emphasized that most of these invasive investigations, including transvenous liver biopsy, are significantly better tolerated a posteriori by patients than other clinical liver investigations [2]. These results are contrary to the a priori expectation of hepatologists.


Portal Hypertension Hepatic Vein Esophageal Varix Hepatic Blood Flow Portal Pressure 


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Copyright information

© Springer Japan 1991

Authors and Affiliations

  • Didier Lebrec
    • 1
  1. 1.Laboratoire d’Hémodynamique Splanchique, Unité de Recherches de Physiopathologie Hépatique, INSERM U24 et Service d’HépatologieHôpital BeaujonClichyFrance

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