Portal Hypertension Workup by DSA

Abstract

To provide information for preoperative planning, combined, selective intravenous (IV) and intraarterial (IA) digital subtraction angiography (DSA) studies were performed on 42 portal hypertension patients scheduled for portal systemic shunt procedures. Selective IV-DSA was performed to demonstrate the hepatic venous system, left renal vein, and inferior vena cava. Portal venous anatomy, direction of flow, and portal systemic collaterals were evaluated by selective IA-DSA. In addition, selective IA-DSA was performed postoperatively on 8 patients to assess shunt patency. Technically adequate DSA studies, suitable for surgical planning or postoperative assessment, were obtained in all of the 50 patients examined. Patient or internal organ motion was not a limiting factor in any study. Such use of DSA represents an efficacious, safe, and cost-effective alternative to conventional film-screen angiography for the evaluation of patients with portal hypertension.