Search results for "Portal hypertension"
showing 10 items of 85 documents
The endoscopic measurement of intravascular pressure and flow in oesophageal varices.
1988
Double-balloon enteroscopy-facilitated cyanoacrylate-injection endotherapy of small-bowel varices: an international experience from 2 European tertia…
2019
Background and Aims Small-bowel varices (SBVs) are an uncommon consequence of portal hypertension. Radiologic intervention is usually considered for first-line management. When radiologic intervention is not possible, management options become very limited. The aim of this study was to evaluate the usefulness of double-balloon enteroscopy (DBE)-facilitated cyanoacrylate-injection endotherapy of SBVs. Methods This was a retrospective review of DBE-facilitated cyanoacrylate-injection endotherapy of SBVs (December 2015 to October 2016). Results Ten DBEs were performed in 6 patients (4 women; median age, 68.5 years). No radiologic or surgical options were deemed feasible. Thirteen nests of SBVs…
Prevention of Upper Gastrointestinal Bleeding in Cirrhotic Patients
1987
The prevalence of varices in patients with cirrhosis is stated to be about 50% and the risk of variceal bleeding 40% with mortality ranging from 30% to 60%. Differences may be due to patient selection and diagnostic criteria. The death risk of first bleeding seems to be higher than that of subsequent episodes (Christensen et al. 1981; D’Amico et al. 1986), indicating that the first bleeding episode causes a selection.
The Effect of Glyceryl Trinitrate on the Intravascular Oesophageal Variceal Pressure in Patients with Cirrhosis and Portal Hypertension
1986
Glyceroltrinitrat (GTN) fuhrt zur Erschlaffung der glatten Muskulatur von Blutgefasen. Es wurde daher fur moglich gehalten, das es den Pfortaderhochdruck bei Patienten mit Leberzirrhose vermindern konnte. Mit der kurzlich beschriebenen endoskopischen Feinnadelpunktion von Osophagusvarizen konnte der Einflus von GTN auf den intravasalen Osophagusvarizendruck (IOVD) gemessen werden. Drei Minuten nach sublingualer Gabe von 2.2 mg GTN fiel der IOVD bei 10 Patienten mit Varizen Grad III von 22.8 ± 2.0 mmHg auf 12.0 ± 0.4 mmHg (p◄0.005) und bei sechs Patienten mit Varizen Grad II von 16.3 ± 0.4 mmHg auf 10.0 ± 0.4 mmHg (p◄0.005). Unsere bisherigen Ergebnisse lassen vermuten, das GTN zur Blutstill…
LIVER RELATED EVENTS AND SURVIVAL IN PATIENTS WITH COMPENSATED HCV CIRRHOSIS: THE ROLE OF SUSTAINED VIROLOGICAL RESPONSE TO PEG-IFN BASED THERAPY AND…
2011
Imaging-guided interventions modulating portal venous flow: Evidence and controversies
2021
Portal hypertension is defined by an increase in the portosystemic venous gradient. In most cases, increased resistance to portal blood flow is the initial cause of elevated portal pressure. More than 90% of cases of portal hypertension are estimated to be due to advanced chronic liver disease or cirrhosis. Transjugular intrahepatic portosystemic shunts, a non-pharmacological treatment for portal hypertension, involve the placement of a stent between the portal vein and the hepatic vein or inferior vena cava which helps bypass hepatic resistance. Portal hypertension may also be a result of extrahepatic portal vein thrombosis or compression. In these cases, percutaneous portal vein recanalis…
Heart rate variability is associated with disease severity and portal hypertension in cirrhosis
2023
Introduction: Autonomic nervous system activity in cirrhotic portal hypertension is linked to hyperdynamic circulation. Heart rate variability (HRV) is a validated noninvasive method to assess the sympathovagal balance. To investigate the correlation between HRV parameters and degree of portal hypertension, we studied a cohort of patients with cirrhosis accounting for etiology and treatments. Patients and Methods: In this cross-sectional, observational cohort study, 157 outpatients of both sex with nonalcoholic cirrhosis were assessed by upper gastrointestinal endoscopy to search for esophagogastric varices. Twenty-four-hour electrocardiogram Holter monitoring with 3 HRV parameters measurem…
Circulating levels of 3-hydroxymyristate, a direct quantification of endotoxaemia in noninfected cirrhotic patients
2019
IF 4.5; International audience; Background & AimsThe quantification of lipopolysaccharide (LPS) in biological fluids is challenging. We aimed to measure plasma LPS concentration using a new method of direct quantification of 3‐hydroxymyristate (3‐HM), a lipid component of LPS, and to evaluate correlations between 3‐HM and markers of liver function, endothelial activation, portal hypertension and enterocyte damage.MethodsPlasma from 90 noninfected cirrhotic patients (30 Child‐Pugh [CP]‐A, 30 CP‐B, 30 CP‐C) was prospectively collected. The concentration of 3‐HM was determined by high‐performance liquid chromatography coupled with mass spectrometry.Results3‐HM levels were higher in CP‐C patien…
New clinical and pathophysiological perspectives defining the trajectory of cirrhosis
2021
Traditionally, the complications of cirrhosis, namely variceal bleeding, ascites and hepatic encephalopathy, were thought to result predominantly from circulatory dysfunction and altered organ perfusion arising as a result of portal hypertension. Over the past 20 years, large, international prospective studies have indicated the importance of systemic inflammation and organ immunopathology as additional determinants of organ dysfunction in cirrhosis, which not only manifests in the liver, brain, circulation and the kidneys, but also the immune system, gut, muscles, adrenal glands, reproductive organs, heart and lungs. This review provides an overview of the traditional and emerging concepts…
Systematic review with meta-analysis: the haemodynamic effects of carvedilol compared with propranolol for portal hypertension in cirrhosis
2013
Summary Background Propranolol is recommended for prophylaxis of variceal bleeding in cirrhosis. Carvedilol is a nonselective beta-blocker with a mild anti-alfa-1-adrenergic activity. Several studies have compared carvedilol and propranolol, yielding inconsistent results. Aim To perform a systematic review and meta-analysis of the randomised clinical trials comparing carvedilol with propranolol for hepatic vein pressure gradient reduction. Methods Studies were searched on the MEDLINE, EMBASE and Cochrane library databases up to November 2013. The weighted mean difference in percent hepatic vein pressure gradient reduction and the relative risk of failure to achieve a hemodynamic response (r…