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Volume 116, Issue 4, Pages (April 1999)

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Presentation on theme: "Volume 116, Issue 4, Pages (April 1999)"— Presentation transcript:

1 Volume 116, Issue 4, Pages 906-914 (April 1999)
Hepatic arterial flow volume and reserve in patients with cirrhosis: Use of intra-arterial Doppler and adenosine infusion  Gerhard Kleber, Norbert Steudel, Curd Behrmann, Alexander Zipprich, Georg Hübner, Erich Lotterer, Wolfgang E. Fleig  Gastroenterology  Volume 116, Issue 4, Pages (April 1999) DOI: /S (99) Copyright © 1999 American Gastroenterological Association Terms and Conditions

2 Fig. 1 Representative example of instantaneous hepatic arterial flow velocity profile as assessed by intravascular Doppler flowmetry of a patient at (A) baseline and (B) during infusion of 40 μg · min−1 · kg body wt−1 adenosine into the hepatic artery. Note the different scales for flow velocities (cm/s) as displayed on the right margins. Gastroenterology  , DOI: ( /S (99) ) Copyright © 1999 American Gastroenterological Association Terms and Conditions

3 Fig. 1 Representative example of instantaneous hepatic arterial flow velocity profile as assessed by intravascular Doppler flowmetry of a patient at (A) baseline and (B) during infusion of 40 μg · min−1 · kg body wt−1 adenosine into the hepatic artery. Note the different scales for flow velocities (cm/s) as displayed on the right margins. Gastroenterology  , DOI: ( /S (99) ) Copyright © 1999 American Gastroenterological Association Terms and Conditions

4 Fig. 2 Typical example of gradually changing APV and PI calculated online from the flow velocity profile in a patient receiving increasing doses of adenosine infused into the hepatic artery. Gastroenterology  , DOI: ( /S (99) ) Copyright © 1999 American Gastroenterological Association Terms and Conditions

5 Fig. 3 (A) Right hepatic arteriogram with (B) magnification and diameter assessment. The vessel is perfused with adenosine via the IA catheter (visible on A). Intravascular Doppler flowmetry is performed as described. The Doppler wire (not visible on the films) is advanced under fluoroscopic control to focus Doppler insonation to the point at which diameter assessment (B) is performed. A catheter is also present in the hepatic vein. Gastroenterology  , DOI: ( /S (99) ) Copyright © 1999 American Gastroenterological Association Terms and Conditions

6 Fig. 3 (A) Right hepatic arteriogram with (B) magnification and diameter assessment. The vessel is perfused with adenosine via the IA catheter (visible on A). Intravascular Doppler flowmetry is performed as described. The Doppler wire (not visible on the films) is advanced under fluoroscopic control to focus Doppler insonation to the point at which diameter assessment (B) is performed. A catheter is also present in the hepatic vein. Gastroenterology  , DOI: ( /S (99) ) Copyright © 1999 American Gastroenterological Association Terms and Conditions

7 Fig. 4 Relationship between (A and B) baseline HABF (mL/min) and (C and D) adenosine-induced ΔHABF assessed by intravascular Doppler flowmetry and prothrombin ratio (expressed as % of normal; A and C) or CO (B and D). Gastroenterology  , DOI: ( /S (99) ) Copyright © 1999 American Gastroenterological Association Terms and Conditions

8 Fig. 5 APV and PI as assessed by intravascular Doppler flowmetry with increasing doses of adenosine infused into the hepatic artery (dose-response curve) in patients with cirrhosis (*P < vs. baseline). Gastroenterology  , DOI: ( /S (99) ) Copyright © 1999 American Gastroenterological Association Terms and Conditions


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