Effects of splenic artery occlusion on portal pressure in patients with cirrhosis and portal hypertension

Angelo Luca, Roberto Miraglia, Settimo Caruso, Mariapina Milazzo, Bruno Gridelli, Jaime Bosch

Research output: Contribution to journalArticle

Abstract

The specific contribution of splenic blood inflow to portal hypertension in patients with cirrhosis is still unclear. In this study, we investigated this contribution by assessing the hemodynamic effects of transient splenic artery occlusion. In 15 cirrhotic patients, portal pressure gradient (PPG) was measured just before inserting a transjugular intrahepatic portosystemic shunt (TIPS), in baseline conditions, for 15 minutes after splenic artery occlusion and 5 minutes after recovery. Splenic artery occlusion caused a significant decrease in PPG (range, -4% to -38%, median -20%, P <0.001) which promptly returned to baseline values after recovery of the splenic inflow. The decrease in PPG showed a significant correlation with spleen volume (r = 0.70, P <0.005), liver volume (r = -0.63; P <0.01), and spleen /liver volume ratio (r = 0.82, P <0.001). Seven out of eight patients with a spleen/liver volume ratio greater than 0.5 had a marked decrease in PPG (>20%), whereas none of patients with a ratio lesser than 0.5 had a marked PPG response. In conclusion, in cirrhotic patients with portal hypertension, splenic artery occlusion causes a significant reduction in portal pressure (PPG). The drop in PPG is directly related to spleen volume and indirectly related to liver volume. The spleen /liver volume ratio accurately predicts the drop in PPG and may be used to identify patients who could obtain a significant advantage from surgical and nonsurgical procedures decreasing splenic inflow.

Original languageEnglish
Pages (from-to)1237-1243
Number of pages7
JournalLiver Transplantation
Volume12
Issue number8
DOIs
Publication statusPublished - Aug 2006

Fingerprint

Splenic Artery
Portal Pressure
Portal Hypertension
Fibrosis
Spleen
Transjugular Intrahepatic Portasystemic Shunt
Liver
Hemodynamics

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Effects of splenic artery occlusion on portal pressure in patients with cirrhosis and portal hypertension. / Luca, Angelo; Miraglia, Roberto; Caruso, Settimo; Milazzo, Mariapina; Gridelli, Bruno; Bosch, Jaime.

In: Liver Transplantation, Vol. 12, No. 8, 08.2006, p. 1237-1243.

Research output: Contribution to journalArticle

@article{e8eec602ebc340dab3f2bdd249269124,
title = "Effects of splenic artery occlusion on portal pressure in patients with cirrhosis and portal hypertension",
abstract = "The specific contribution of splenic blood inflow to portal hypertension in patients with cirrhosis is still unclear. In this study, we investigated this contribution by assessing the hemodynamic effects of transient splenic artery occlusion. In 15 cirrhotic patients, portal pressure gradient (PPG) was measured just before inserting a transjugular intrahepatic portosystemic shunt (TIPS), in baseline conditions, for 15 minutes after splenic artery occlusion and 5 minutes after recovery. Splenic artery occlusion caused a significant decrease in PPG (range, -4{\%} to -38{\%}, median -20{\%}, P <0.001) which promptly returned to baseline values after recovery of the splenic inflow. The decrease in PPG showed a significant correlation with spleen volume (r = 0.70, P <0.005), liver volume (r = -0.63; P <0.01), and spleen /liver volume ratio (r = 0.82, P <0.001). Seven out of eight patients with a spleen/liver volume ratio greater than 0.5 had a marked decrease in PPG (>20{\%}), whereas none of patients with a ratio lesser than 0.5 had a marked PPG response. In conclusion, in cirrhotic patients with portal hypertension, splenic artery occlusion causes a significant reduction in portal pressure (PPG). The drop in PPG is directly related to spleen volume and indirectly related to liver volume. The spleen /liver volume ratio accurately predicts the drop in PPG and may be used to identify patients who could obtain a significant advantage from surgical and nonsurgical procedures decreasing splenic inflow.",
author = "Angelo Luca and Roberto Miraglia and Settimo Caruso and Mariapina Milazzo and Bruno Gridelli and Jaime Bosch",
year = "2006",
month = "8",
doi = "10.1002/lt.20762",
language = "English",
volume = "12",
pages = "1237--1243",
journal = "Liver Transplantation",
issn = "1527-6465",
publisher = "John Wiley and Sons Ltd",
number = "8",

}

TY - JOUR

T1 - Effects of splenic artery occlusion on portal pressure in patients with cirrhosis and portal hypertension

AU - Luca, Angelo

AU - Miraglia, Roberto

AU - Caruso, Settimo

AU - Milazzo, Mariapina

AU - Gridelli, Bruno

AU - Bosch, Jaime

PY - 2006/8

Y1 - 2006/8

N2 - The specific contribution of splenic blood inflow to portal hypertension in patients with cirrhosis is still unclear. In this study, we investigated this contribution by assessing the hemodynamic effects of transient splenic artery occlusion. In 15 cirrhotic patients, portal pressure gradient (PPG) was measured just before inserting a transjugular intrahepatic portosystemic shunt (TIPS), in baseline conditions, for 15 minutes after splenic artery occlusion and 5 minutes after recovery. Splenic artery occlusion caused a significant decrease in PPG (range, -4% to -38%, median -20%, P <0.001) which promptly returned to baseline values after recovery of the splenic inflow. The decrease in PPG showed a significant correlation with spleen volume (r = 0.70, P <0.005), liver volume (r = -0.63; P <0.01), and spleen /liver volume ratio (r = 0.82, P <0.001). Seven out of eight patients with a spleen/liver volume ratio greater than 0.5 had a marked decrease in PPG (>20%), whereas none of patients with a ratio lesser than 0.5 had a marked PPG response. In conclusion, in cirrhotic patients with portal hypertension, splenic artery occlusion causes a significant reduction in portal pressure (PPG). The drop in PPG is directly related to spleen volume and indirectly related to liver volume. The spleen /liver volume ratio accurately predicts the drop in PPG and may be used to identify patients who could obtain a significant advantage from surgical and nonsurgical procedures decreasing splenic inflow.

AB - The specific contribution of splenic blood inflow to portal hypertension in patients with cirrhosis is still unclear. In this study, we investigated this contribution by assessing the hemodynamic effects of transient splenic artery occlusion. In 15 cirrhotic patients, portal pressure gradient (PPG) was measured just before inserting a transjugular intrahepatic portosystemic shunt (TIPS), in baseline conditions, for 15 minutes after splenic artery occlusion and 5 minutes after recovery. Splenic artery occlusion caused a significant decrease in PPG (range, -4% to -38%, median -20%, P <0.001) which promptly returned to baseline values after recovery of the splenic inflow. The decrease in PPG showed a significant correlation with spleen volume (r = 0.70, P <0.005), liver volume (r = -0.63; P <0.01), and spleen /liver volume ratio (r = 0.82, P <0.001). Seven out of eight patients with a spleen/liver volume ratio greater than 0.5 had a marked decrease in PPG (>20%), whereas none of patients with a ratio lesser than 0.5 had a marked PPG response. In conclusion, in cirrhotic patients with portal hypertension, splenic artery occlusion causes a significant reduction in portal pressure (PPG). The drop in PPG is directly related to spleen volume and indirectly related to liver volume. The spleen /liver volume ratio accurately predicts the drop in PPG and may be used to identify patients who could obtain a significant advantage from surgical and nonsurgical procedures decreasing splenic inflow.

UR - http://www.scopus.com/inward/record.url?scp=33746913941&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33746913941&partnerID=8YFLogxK

U2 - 10.1002/lt.20762

DO - 10.1002/lt.20762

M3 - Article

C2 - 16741929

AN - SCOPUS:33746913941

VL - 12

SP - 1237

EP - 1243

JO - Liver Transplantation

JF - Liver Transplantation

SN - 1527-6465

IS - 8

ER -