Systematic review: Endoscopic and imaging-based techniques in the assessment of portal haemodynamics and the risk of variceal bleeding

Alimentary Pharmacology and Therapeutics

Volumn 30, Issue 10, 2009, Pages 965-976

  Sgouros, S N ^a   Vasiliadis, K V ^a   Pereira, S P ^a,b  

^a UNIVERSITY COLLEGE LONDON   (United Kingdom)

^b ROYAL FREE AND UNIVERSITY COLLEGE MEDICAL SCHOOL   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

COLOR ULTRASOUND FLOWMETRY; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; CONTROLLED STUDY; ENDOSCOPIC ECHOGRAPHY; ENDOSCOPIC THERAPY; HUMAN; MAGNETIC RESONANCE ANGIOGRAPHY; MULTIDETECTOR COMPUTED TOMOGRAPHY; PORTAL HYPERTENSION; PORTAL VEIN BLOOD PRESSURE; PRIORITY JOURNAL; REVIEW; SYSTEMATIC REVIEW; VARICOSIS;

ENDOSCOPY; ESOPHAGEAL AND GASTRIC VARICES; GASTROINTESTINAL HEMORRHAGE; HUMANS; HYPERTENSION, PORTAL; MAGNETIC RESONANCE ANGIOGRAPHY; PORTAL PRESSURE; PORTAL SYSTEM; RISK FACTORS; ULTRASONOGRAPHY, DOPPLER;

EID: 71949124296     PISSN: 02692813     EISSN: 13652036     Source Type: Journal    
DOI: 10.1111/j.1365-2036.2009.04135.x     Document Type: Review

References (93)

1. Thalheimer U, Leandro G, Samonakis DN, Triantos CK, Patch D, Burroughs AK. Assessment of the agreement between wedge hepatic vein pressure and portal vein pressure in cirrhotic patients. Dig Liver Dis 2005 37 : 601 608.
2. Groszmann RJ, Wongcharatrawee S. The hepatic venous pressure gradient: anything worth doing should be done right. Hepatology 2004 39 : 280 283.
3. Burroughs AK, Groszmann R, Bosch J, et al. Assessment of therapeutic benefit of antiviral therapy in chronic hepatitis C: is hepatic venous pressure gradient a better end point? Gut 2002 50 : 425 427.
4. De Franchis R. Evaluation and follow-up of patients with cirrhosis and oesophageal varices. J Hepatol 2003 38 : 361 363.
5. Bosch J, Garcia-Pagan JC. Prevention of variceal rebleeding. Lancet 2003 361 : 952 954.
6. Hicken BL, Sharara BI, Abrams GA, et al. Hepatic venous pressure gradient measurements to assess response to primary prophylaxis in patients with cirrhosis: a decision analytical study. Aliment Pharmacol Ther 2003 17 : 145 153.
7. Thalheimer U, Mela M, Patch D, Burroughs AK. Monitoring target reduction in hepatic venous pressure gradient during pharmacological therapy of portal hypertension: a close look at the evidence. Gut 2004 53 : 143 148.
8. Keiding S, Vilstrup H. Intrahepatic heterogeneity of hepatic venous pressure gradient in human cirrhosis. Scand J Gastroenterol 2002 37 : 960 964. (Pubitemid 34969932)
9. Afdhal NH, Nunes D. Evaluation of liver fibrosis: a concise review. Am J Gastroenterol 2004 99 : 1160 1174.
10. Salcedo X, Medina J, Sanz-Cameno P, Garcia-Buey L, Martin-Vilchez S, Moreno-Otero R. Review article: angiogenesis soluble factors as liver disease markers. Aliment Pharmacol Ther 2005 22 : 23 30.
11. The North Italian Endoscopic Club for the Study and Treatment of Esophageal Varices. Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study. N Engl J Med 1988 319 : 983 989.
12. Cottone M, D'Amico G, Maringhini A, et al. Predictive value of ultrasonography in the screening of non-ascitic cirrhotic patients with large varices. J Ultrasound Med 1986 5 : 189 192.
13. Fook-Hong NG, Siu-Yin W, Ching-Hong L, Kwong-Ming L, Chi-Wing L, Chi-Sing C. Prediction of esophageal varices in patients with liver cirrhosis. J Gastroenterol Hepatol 1999 14 : 785 790.
14. Chalasani N, Imperiale TF, Ismail A, Sood G, Carey M, Mel Wilcox C. Predictors of large esophageal varices in patients with cirrhosis. Am J Gastroenterol 1999 94 : 3285 3291.
15. Pilette C, Oberti F, Aub C, et al. Non-invasive diagnosis of esophageal varices in chronic liver diseases. J Hepatol 1999 31 : 867 873.
16. Zaman A, Hapke R, Flora K, Rosen HR, Benner K. Factors predicting the presence of esophageal or gastric varices in patients with advanced liver disease. Am J Gastroenterol 1999 94 : 3292 3296.
17. Madhotra R, Mulcahy HE, Willner I, Reuben A. Prediction of esophageal varices in patients with cirrhosis. J Clin Gastroenterol 2002 34 : 81 5.
18. Schepis F, Cammà C, Niceforo D, et al. Which patients with cirrhosis should undergo endoscopic screening for esophageal varices detection? Hepatology 2001 33 : 333 338.
19. Giannini E, Botta F, Borro P, Risso D, Romagnoli P, Fasoli A. Platelet count/spleen diameter ratio: proposal and validation of a non-invasive parameter to predict the presence of oesophageal varices in patients with liver cirrhosis. Gut 2003 52 : 1200 1205.
20. Thomopoulos KC, Labropoulou-Karatza C, Mimidis KP, Katsakoulis EC, Iconomou G, Nikolopoulou VN. Non-invasive predictors of the presence of large oesophageal varices in patients with cirrhosis. Dig Liver Dis 2003 35 : 473 478.
21. Zein CO, Lindor KD, Angulo P. Prevalence and predictors of esophageal varices in patients with primary sclerosing cholangitis. Hepatology 2004 39 : 203 209.
22. Vanbiervliet G, Barjoan-Marine E, Anty R, et al. Serum fibrosis markers can detect large oesophageal varices with a high accuracy. Eur J Gastroenterol Hepatol 2005 17 : 333 338.
23. Alempijevic T, Bulat V, Djuranovic S, et al. Right liver lobe/albumin ratio: contribution to non-invasive assessment of portal hypertention. World J Gastroenterol 2007 13 : 5331 5335.
24. Gallego C, Velasco M, Marcuello P, Tejedor D, De Campo L, Friera A. Congenital and acquired anomalies of the portal venous system. Radiographics 2002 22 : 141 159.
25. Henseler KP, Pozniak MA, Lee FD, Winter TC. Three-dimensional CT angiography of spontaneous portosystemic shunts. Radiographics 2001 21 : 691 704.
26. Chu Q, Li Z, Zhang SM, Hu DY, Xiao M. Relationship between encephalopathy and portal vein-vena cava shunt: value of computed tomography during arterial portography. World J Gastroenterol 2004 10 : 1939 1942.
27. Willmann JK, Weishaupt D, Böhm T, et al. Detection of submucosal gastric fundal varices with multi-detector row CT angiography. Gut 2003 52 : 886 892.
28. Matsumoto A, Kitamoto M, Imamura M, et al. Three-dimensional portography using multislice helical CT is clinically useful for management of gastric fundic varices. AJR Am J Roentgenol 2001 176 : 899 905.
29. Moller S, Bendtsen F, Christensen E, Henriksen JH. Prognostic variables in patients with cirrhosis and oesophageal varices without prior bleeding. J Hepatol 1994 21 : 940 946.
30. Bosch J, Groszmann RJ. Measurement of azygos venous blood flow by a continuous thermal dilution technique: an index of blood flow through gastroesophageal collaterals in cirrhosis. Hepatology 1984 4 : 424 429.
31. Lomas DJ, Hayball MP, Jones DP, Sims C, Allison ME, Alexander GJ. Non-invasive measurement of azygos venous blood flow using magnetic resonance. J Hepatol 1995 22 : 399 403.
32. Wu MT, Pan HB, Chen C, et al. Azygos blood flow in cirrhosis: measurement with MR imaging and correlation with variceal hemorrhage. Radiology 1996 198 : 457 462.
33. Calès P, Braillon A, Jiron MI, Lebrec D. Superior portosystemic collateral circulation estimated by azygos blood flow in patients with cirrhosis: lack of correlation with esophageal varices and gastrointestinal bleeding: effect of propranolol. J Hepatol 1984 1 : 37 46.
34. Sugano S, Yamamoto K, Sasao KI, Ishii K, Watanabe M, Tanikawa K. Daily variation of azygos and portal blood flow and the effect of propranolol administration once an evening in cirrhotics. J Hepatol 2001 34 : 26 31.
35. Alvarez D, de las Heras M, Abecasis R, et al. Daily variation in portal blood flow and the effect of propranolol administration in a randomized study of patients with cirrhosis. Hepatology 1997 25 : 548 550.
36. Burkart DJ, Johnson CD, Morton MJ, Wolf RL, Ehrman RL. Volumetric flow rates in the portal venous system: measurement with cine phase-contrast MR imaging. AJR Am J Roentgenol 1993 160 : 1113 1118.
37. Leung DA, Kinnon GC, Davis CP, Pfammatter T, Krestin GP, Debatin JF. Breath-hold, contrast-enhanced, three-dimensional MR angiography. Radiology 1996 200 : 569 571.
38. Yamashita Y, Mitsuzaki K, Miyazaki T, et al. Gadolinium-enhanced breath-hold three-dimensional MR angiography of the portal vein: value of magnetization-prepared rapid acquisition gradient echo sequence. Radiology 1996 201 : 283 288.
39. Ernst O, Asnar V, Sergent G, et al. Comparing contrast-enhanced breath-hold MR Angiography and conventional angiography. AJR Am J Roentgenol 2000 174 : 433 439.
40. Annet L, Materne R, Danse E, Jamart J, Horsmans Y, Van Beers BE. Hepatic flow parameters measured with MR Imaging and Doppler ultrasound: Correlations with degree of cirrhosis and portal hypertension. Radiology 2003 229 : 409 414.
41. Liu H, Cao H, Wu ZY. Magnetic resonance angiography in the management of patients with portal hypertention. Hepatobiliary Pancreat Dis Int 2005 4 : 239 243.
42. Nishida N, Sakai G, Morimoto A, et al. Gadolinium enhanced three-dimensional magnetic resonance portography with subtraction. Br J Radiol 2001 74 : 147 152.
43. Kleber G, Sauerbruch T, Fischer G, et al. Pressure of intraoesophageal varices assessed by fine needle puncture: Its relation to endoscopic signs and severity of liver disease in patients with cirrhosis. Gut 1989 30 : 228 232.
44. Sarin SK, Sethi KK, Nanda R. Measurement and correlation of wedged hepatic, intrahepatic, intrasplenic and intravariceal pressures in patients with cirrhosis of liver and non-cirrhotic portal fibrosis. Gut 1987 28 : 260 266.
45. Rigau J, Bosch J, Bordas JM, et al. Endoscopic measurement of variceal pressure in cirrhosis: correlation with portal pressure and variceal hemorrhage. Gastroenterology 1989 96 : 873.
46. Bosch J, Bordas JM, Rigau J, et al. Non-invasive measurement of the pressure of esophageal varices using an endoscopic gauge: comparison with measurements by variceal puncture in patients undergoing endoscopic sclerotherapy. Hepatology 1986 6 : 667.
47. Atti EA, Nevens F, Bogaerts K, et al. Variceal pressure is a strong predictor of variceal haemorrhage in patients with cirrhosis as well as in patients with non-cirrhotic portal hypertension. Gut 1999 45 : 618.
48. Nevens F, Bustami R, Scheys I, et al. Variceal pressure is a factor predicting the risk of a first variceal bleeding: a prospective cohort study in cirrhotic patients. Hepatology 1998 27 : 15.
49. Nevens F, Van Steenbergen W, Yap SH, Fevery J. Assessment of variceal pressure by continuous non-invasive endoscopic registration: a placebo controlled evaluation of the effect of terlipressin and octreotide. Gut 1996 38 : 129 134.
50. Nevens F, Sprengers D, Feu F, Bosch J, Fevery J. Measurement of variceal pressure with an endoscopic pressure sensitive gauge: validation and effect of propranolol therapy in chronic conditions. J Hepatol 1996 24 : 66 73.
51. Nevens F, Lijnen P, VanBilloen H, Fevery J. The effect of long-term treatment with spironolactone on variceal pressure in patients with portal hypertension without ascites. Hepatology 1996 23 : 1047 1052.
52. Gertsch P, Fischer G, Kleber G, et al. Manometry of esophageal varices: comparison of an endoscopic balloon technique with needle puncture. Gastroenterology 1993 105 : 1159 1166.
53. Pontes JM, Leitão MC, Portela F, Nunes A, Freitas D. Endosonographic Doppler-guided manometry of esophageal varices: experimental validation and clinical feasibility. Endoscopy 2002 34 : 966 972.
54. Miller ES, Kim JK, Gandehok J, et al. A new esophageal variceal pressure measuring device. Gastrointest Endosc 2002 56 : 284 291.
55. Miller LS, Dai O, Thomas A, et al. A new ultrasound-guided esophageal variceal pressure-measuring device. Am J Gastroenterol 2004 99 : 1267 1273.
56. Spahr L, Giostra E, Morard I, Mentha G, Hadengue A. Parendoscopic variceal pressure measurement. A reliable estimation of portal pressure in patients with cirrhosis? Gastroenterol Clin Biol 2006 30 : 1012 1018.
57. Kruskal JB, Newman PA, Sammons LG, Kane RA. Optimizing Doppler and Color Flow US: application to Hepatic Sonography. RadioGraphics 2004 24 : 657 675.
58. Kok T, van der Jargt EJ, Haagsma EB, Bijleveld CMA, Jansen PLM, Boeve WL. The value of Doppler ultrasound in cirrhosis and portal hypertension. Scand J Gastroenetrol suppl 1999 230 : 82 8.
59. Taourel P, Blanc P, Dauzat M, et al. Doppler study of mesenteric, hepatic, and portal circulation in alcoholic cirrhosis: relationship between quantitative Doppler measurements and the severity of portal hypertension and hepatic failure. Hepatology 1998 28 : 932 936.
60. Schneider AW, Kalk JF, Klein CP. Hepatic arterial pulsatility index in cirrhosis: correlation with portal pressure. J Hepatol 1999 30 : 876 881.
61. Tarzamni MK, Somi MH, Farhang S, Jalilvand M. Portal hemodynamics as predictors of high risk esophageal varices in cirrhotic patients. World J Gastroenterol 2008 14 : 1898 1902.
62. Iwao T, Oho K, Sakai T, et al. Noninvasive hemodynamic measurements of superior mesenteric artery in the prediction of portal pressure response to propranolol. J Hepatol 1998 28 : 847 855.
63. Albillos A, Perez-Paramo M, Cacho G, et al. Accuracy of portal and forearm blood flow measurements in the assessment of the portal pressure response to propranolol. J Hepatol 1997 27 : 496 504.
64. Schepke M, Raab P, Hoppe A, Schiedermaier P, Brensing KA, Sauerbruch T. Comparison of portal vein velocity and the hepatic venous pressure gradient in assessing the acute portal hemodynamic response to propranolol in patients with cirrhosis. Am J Gastroenterol 2000 95 : 2905 2909.
65. Koo BS, Ho JP, Sang Won J, et al. Acute hemodynamic effects of octreotide and terlipressin in patients with cirrhosis: a randomized comparison. Am J Gastroenterol 2005 100 : 631 635.
66. Baik SK, Park DH, Kim MY, et al. Captopril reduces portal pressure effectively in portal hypertensive patients with low portal venous velocity. J Gastroenterol 2003 38 : 1150 1154.
67. Luca A, Garcia-Pagan JC, Bosch J, et al. Effects of ethanol consumption on hepatic hemodynamics in patients with alcoholic cirrhosis. Gastroenterology 1997 112 : 1284 1289.
68. Luca A, Garcia-Pagan JC, Feu F, et al. Noninvasive measurement of femoral blood flow and portal pressure response to propranolol in patients with cirrhosis. Hepatology 1995 21 : 83 8.
69. Schiedermaier P, Koch L, Stoffel-Wagner B, Layer G, Sauerbruch T. Effect of propranolol and depot lanreotide SR on postprandial and circadian portal haemodynamics in cirrhosis. Aliment Pharmacol Ther 2003 18 : 777 784.
70. Merkel C, Sacerdoti D, Bolognesi M, Bombonato G, Gatta A. Doppler sonography and hepatic vein catheterization in portal hypertension: assessment of agreement in evaluating severity and response to treatment. J Hepatol 1998 28 : 622 630.
71. Choi YJ, Baik SK, Park DH, et al. Comparison of Doppler ultrasonography and the hepatic venous pressure gradient in assessing portal hypertension in liver cirrhosis. J Gastroenterol Hepatol 2003 18 : 424 429.
72. Castano G, Viudez P, Riccitelli M, Sookoian S. A randomized study of losartan vs propranolol: effects on hepatic and systemic hemodynamics in cirrhotic patients. Ann Hepatol 2003 2 : 36 40.
73. Albillos A, Garcia-Pagan JC, Iborra J, et al. Propranolol plus prazosin compared with propranolol plus isosorbide-5-mononitrate in the treatment of portal hypertension. Gastroenterology 1998 115 : 116 123.
74. Bandi JC, Garcia-Pagan JC, Escorsell A, et al. Effects of propranolol on the hepatic hemodynamic response to physical exercise in patients with cirrhosis. Hepatology 1998 28 : 677 682.
75. Kim MY, Baik SK, Park DH, et al. Damping index of Doppler hepatic vein waveform to assess the severity of portal hypertension and response to propranolol in liver cirrhosis: a prospective nonrandomized study. Liver int 2007 27 : 1103 1110.
76. Schiedermaier P, Layer G, Sauerbruch T. Impact of the continuous infusion of levovist on color doppler sonography in portal hypertension. AJR Am J Radiol 2002 178 : 61 5.
77. Burtin P, Calès P, Oberti F, et al. Endoscopic ultrasound signs of portal hypertension in cirrhosis. Gastrointest Endosc 1996 44 : 257 261.
78. Boustiere C, Dumas O, Jouffre C, et al. Endoscopic ultrasonography classification of gastric varices in patients with cirrhosis: comparison with endoscopic findings. J Hepatol 1993 19 : 268 272.
79. Lee YT, Chan FK, Ching JY, et al. Diagnosis of gastroesophageal varices and portal collateral venous abnormalities by endosonography in cirrhotic patients. Endoscopy 2002 34 : 391 398.
80. Sgouros SN, Bergele C, Avgerinos A. Endoscopic ultrasonography in the diagnosis and management of portal hypertension. Where are we next?. Dig Liver Dis 2006 38 : 289 295.
81. Schiano TD, Adrain AL, Cassidy MJ, et al. Use of high-resolution endoluminal sonography to measure the radius and wall thickness of esophageal varices. Gastrointest Endosc 1996 44 : 425 428.
82. Escorsell A, Bordas JM, Feu F, et al. Endoscopic assessment of variceal volume and wall tension in cirrhotic patients: effect of pharmacological therapy. Gastroenterology 1997 113 : 1640 1646.
83. Miller L, Banson FL, Bazir K, et al. Risk of esophageal variceal bleeding based on endoscopic ultrasound evaluation of the sum of esophageal variceal cross-sectional surface area. Am J Gastroenterol 2003 98 : 454 459.
84. Sukigara M, Shimoji K, Ohata M, et al. Effects of propranolol and nitroglycerin on cephalad collateral venous flow in patients with cirrhosis: evaluation using transesophageal real-time two-dimensional Doppler echography. Am J Gastroenterol 1988 83 : 1248 1254.
85. Lee YT, Sung JY, Yung MY, Yu ALM, Chung SCS. The use of color Doppler EUS in assessing azygos blood flow for patients with portal hypertension. Gastrointest Endosc 1999 50 : 47 52.
86. Hansen EF, Bendsten F, Brinch K, Moller S, Henriksen JH, Becker U. Endoscopic Doppler ultrasound for measurement of azygos blood flow. Validation against thermodilution and assessment of pharmacological effects of terlipressin in portal hypertension. Scand J Gastroenterol 2001 36 : 318 325.
87. Nishida H, Giostra E, Spahr L, Mentha G, Mitamura K, Hadengue A. Validation of color Doppler EUS for azygos blood flow measurement in patients with cirrhosis: application to the acute hemodynamic effects of somatostatin, octreotide, or placebo. Gastrointest Endosc 2001 54 : 24 30.
88. Leung VK, Sung JJ, Ahuja AT, et al. Large para-oesophageal varices on endosonography predict recurrence of oesophageal varices and rebleeding. Gastroenterology 1997 112 : 1811 1816.
89. Lo GH, Lai KH, Cheng JS, Huang RL, Wang SJ, Chiang HT. Prevalence of para-esophageal varices and gastric varices in patients achieving variceal obliteration by banding ligation and by injection sclerotherapy. Gastrointest Endosc 1999 49 : 428 436.
90. Suzuki T, Matsutani S, Umebara K, et al. EUS changes predictive for recurrence of esophageal varices in patients treated by combined endoscopic ligation and sclerotherapy. Gastrointest Endosc 2000 52 : 611 617.
91. Irisawa A, Saito A, Obara K, et al. Endoscopic recurrence of esophageal varices is associated with specific EUS abnormalities: severe peri-esophageal collateral veins and large perforating veins. Gastrointest Endosc 2001 53 : 77 84.
92. Konishi Y, Nakamura T, Kida H, Seno H, Okazaki K, Chiba T. Catheter US probe EUS evaluation of gastric cardia and perigastric vascular structures to predict esophageal variceal recurrence. Gastrointest Endosc 2002 55 : 197 203.
93. Lai L, Poneros J, Santilli J, Brugge W. EUS-guided portal vein catheterization and pressure measurement in an animal model: a pilot study of feasibility. Gastrointest Endosc 2004 59 : 280 283.