chapter  15
10 Pages

CO2 for Wedged Hepatic Venography

WithKyung J. Cho

Wedged hepatic venography and manometry are frequently used as part of the

angiographic evaluation of patients with cirrhosis and portal hypertension, a transjugular

intrahepatic portosystemic shunt (TIPS) procedure, and transjugular liver biopsy.

Wedged hepatic venous pressure reflects sinusoidal pressure and, in the absence of

portal vein thrombosis, portal pressure. Both iodinated contrast medium and CO2 are

used as contrast agents for wedged hepatic venography. The former provides the infor-

mation about the hepatic morphology and hemodynamics, whereas the latter can better

visualize the portal venous anatomy. The combination of CO2 wedged hepatic venogra-

phy, hepatic manometry, and transjugular liver biopsy represent a “one-stop shopping”

study for the evaluation of the hepatic-portal disorders.