Analysis of Portal Hemodynamics in Patients with Esophageal Varices : The Efficacy of Left Gastric Arteriography
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概要
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To clarify the efficacy of left gastric arteriography in patients with esophageal varices, portal hemodynamics were analyzed using DSA in 357 patients with esophageal varices. 1) On superior mesenteric arteriography and splenic arteriography, left gastric vein (LGV) and/or short gastric vein (or posterior gastric vein) were depicted in 41% of F<SUB>1</SUB> cases, 72% of F<SUB>2</SUB> cases and 87% of F<SUB>3</SUB> cases. On left gastric arteriography, esophageal varices were depicted in 97%, 100% and 100%, respectively. 2) The direction of LGV was hepatopetal in 50%, to and fro in 22%, hepatofugal in 22%, and undetermined in 6% of F<SUB>1</SUB> cases. As the degree of esophageal varices increased, the incidence of hepatopetal cases and to and fro cases decreased, and that of hepatofugal cases increased. 3) Esophageal varices could be classified into two groups according to their hemodynamics, "left gastric artery-dependent esophageal varices" and "mixed type esophageal varices." The former was mainly supplied with blood flow from the upper gastric area, and comprised about three-fifths of F<SUB>1</SUB> cases and one-fourth of F<SUB>2</SUB> cases. The latter was supplied with portal blood flow and blood flow from the upper gastric area, and filled about three-fourths of F<SUB>2</SUB> cases and most of F<SUB>3</SUB> cases. 4) Repeated angiography after endoscopic treatment demonstrated alternation of blood flow of LGV or decreased LGV diameter in more than half of the "mixed type esophageal varices" cases. The hemodynamics in 62.5% of patients with recurrent varices showed the same hemodynamics as "left gastric artery-dependent esophageal varices."
- The Japan Society for Portal Hypertensionの論文
The Japan Society for Portal Hypertension | 論文
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