5f 65 cm mpa diagnostic catheter

All HVPG measurements were performed via right TJ access under ultrasound guidance by one of 5 experienced interventional radiologists. The mean (range) interval between HVPG measurement and MRI was 28.7 days (1–102 days). Following right or middle hepatic vein catheterization using a 5F 65 cm MPA diagnostic catheter (Cordis, Santa Clara, CA), venography with iodinated contrast was performed. Initially, free hepatic vein pressure was measured through the end-hole of the catheter. The catheter was then advanced to a wedged position, and this was confirmed with contrast injection to observe reflux into portal radicals. Systolic, diastolic, and mean wedge pressures were obtained. HVPG was calculated as the difference between wedge pressure and free mean pressure. Subsequently, a TJ liver biopsy (19G) was performed from the hepatic vein using a TLAB biopsy kit (Argon Medical, Frisco, TX).

The HVPG measurements were performed by 1 of 5 interventional radiologists with over 300 case experience each. A right transjugular access was obtained using ultrasound guidance. A 5F 65cm MPA diagnostic catheter (Cordis, Santa Clara, CA) was used to catheterize the right or middle hepatic vein and venography was performed with iodinated contrast. A standard disposable pressure transducer was used to measure free hepatic vein pressure through the end hole of the catheter. Then the catheter was moved forward into a wedged position and confirmed with contrast injection to visualized reflux into portal radicals. A wedge pressure was obtained from this location. Measurements were obtained after 45–60 seconds to allow for equilibration. Three measurements were obtained: systolic, diastolic and mean. Neither the transducer position nor table height were changed during pressure measurements. HVPG was measured as the difference between wedge pressure – free mean pressure. Following HVPG measurement, a transjugular liver biopsy (19 gauge) was performed from the hepatic vein using a TLAB biopsy kit (Argon Medical, Frisco, TX) in 23 cases. In two patients, a transjugular intrahepatic portosystemic shunt (TIPS) was placed after the initial portal pressure measurement.

HVPG measurements were performed either before or after the MRI (78 ± 48 days, range 3–184 days) by 1 of 5 experienced interventional radiologists. Right transjugular access was obtained using ultrasound guidance, under local anesthesia and moderate conscious sedation. A 5F 65-cm MPA diagnostic catheter (Cordis, Bridgewater, NJ) was used to catheterize the right or middle hepatic vein, and venography was performed with iodinated contrast. Then, a 5.8F 1.0-cm flow-directed occlusion balloon (Cook Medical) catheter was placed in the middle or right hepatic vein. The HVPG was calculated as the difference between wedged and free hepatic venous pressures. Free pressure was measured in the vein with the balloon deflated. Measurements were obtained after 45–60s to allow for equilibration using an NAMIC Preceptor transducer (Navilyst Medical, Marlborough, MA). Then, the balloon was inflated to profile in the vein and the wedge pressure was measured using the same transducer. Two measurements were performed, and an average value was determined.