Diagnostic hepatic haemodynamic techniques: safety and radiation exposure.

Hari, Andrej; Nair, Harikumar; De Gottardi, Andrea; Baumgartner, Iris; Dufour, Jean-François; Berzigotti, Annalisa (2017). Diagnostic hepatic haemodynamic techniques: safety and radiation exposure. Liver international, 37(1), pp. 148-154. Wiley 10.1111/liv.13215

[img] Text
Diagnostic hepatic haemodynamic techniques safety and.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (389kB) | Request a copy

BACKGROUND & AIMS Hepatic venous pressure gradient (HVPG) and transjugular liver biopsy (TJLB) are increasingly used in the management of patients with liver disease. We aimed to describe the safety profile of these procedures, providing data on the intra- and periprocedure complications, radiation exposure and amount of iodinated contrast material used. METHODS In 106 consecutive patients undergoing HVPG and TJLB data on fluoroscopy time (FT), absorbed radiation dose, equivalent effective dose (mSv) and volume of iodinated contrast material (ICM) were prospectively collected and reviewed, together with clinical and laboratory data. Incidence and severity of procedure-related complications were assessed. In 28 hospitalised patients, creatinine values after 72 hours of the procedure were reviewed to identify contrast-induced nephropathy (CIN). RESULTS Median effective radiation dose was 5.4 mSv (IQR 10 mSv). A total 28.3% of patients exceeded an effective exposure of 10 mSv and 9.4% exceeded 20 mSv. Only age and BMI correlated with radiation dose (R = .327, P=.001 and R = .410, P<.0001 respectively), and only BMI remained independently associated with an exposure over 20 mSv. Procedure-related complications occurred in eight patients (7.5%), and were minor in six cases. Median ICM volume was 12.5 mL. 6/28 patients met the diagnostic criteria for CIN. CONCLUSIONS Hepatic venous pressure gradient and Transjugular liver biopsy show a good safety profile and radiation exposure associated with these procedures is in most of the cases low. In hepatic haemodynamic procedures, efforts should be made to reduce the radiation dose in patients with overweight/obesity and to use the minimal possible ICM volume in patients with acute-on-chronic liver failure.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology

UniBE Contributor:

Hari, Andrej; Nair, Harikumar; De Gottardi, Andrea; Baumgartner, Iris; Dufour, Jean-François and Berzigotti, Annalisa

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1478-3231

Publisher:

Wiley

Language:

English

Submitter:

Catherine Gut

Date Deposited:

17 Jul 2017 14:44

Last Modified:

03 Aug 2017 15:42

Publisher DOI:

10.1111/liv.13215

PubMed ID:

27495217

Uncontrolled Keywords:

hepatic venous pressure gradient; iodinated contrast material; obesity; transjugular liver biopsy

BORIS DOI:

10.7892/boris.93045

URI:

https://boris.unibe.ch/id/eprint/93045

Actions (login required)

Edit item Edit item
Provide Feedback