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Garcia-Pagan, JcAuthorEscorsell, AAuthorBosch, JCorresponding Author

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CO2 wedged hepatic venography in the evaluation of portal hypertension

Publicated to:Gut. 46 (6): 856-860 - 2000-06-01 46(6), DOI: 10.1136/gut.46.6.856

Authors: Debernardi-Venon, W; Bandi, JC; García-Pagán, JC; Moitinho, E; Andreu, V; Real, M; Escorsell, A; Montanyá, X; Bosch, J

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Abstract

Background/aims/methods-During hepatic vein catheterisation, in addition to measurement of hepatic venous pressure gradient (HVPG), iodine wedged retrograde portography can be easily obtained. However, it rarely allows correct visualisation of the portal vein. Recently, CO2 has been suggested to allow better angiographic demonstration of the portal vein than iodine. In this study we investigated the efficacy of CO2 compared with iodinated contrast medium for portal vein imaging and its role in the evaluation of portal hypertension in a series of 100 patients undergoing hepatic vein catheterisation, 71 of whom had liver cirrhosis. Results-In the overall series, CO2 venography was markedly superior to iodine, allowing correct visualisation of the different segments of the portal venous system. In addition, CO2, but not iodine, visualised portal-systemic collaterals in 34 patients. In cirrhosis, non-visualisation of the portal vein on CO2 venography occurred in II cases; four had portal vein thrombosis and five had communications between different hepatic veins. Among non-cirrhotics, lack of portal vein visualisation had a 90% sensitivity, 88% specificity, 94% negative predictive value, and 83% positive predictive value in the diagnosis of pre-sinusoidal portal hypertension. Conclusions-Visualisation of the venous portal system by CO2 venography is markedly superior to iodine. The use of CO2 wedged portography is a useful and safe complementary procedure during hepatic vein catheterisation which may help to detect portal thrombosis. Also, lack of demonstration of the portal vein in non-cirrhotic patients strongly suggests the presence of pre-sinusoidal portal hypertension.

Keywords

AssociationCarbon dioxideCarbon-dioxideCirrhosisContrast agentContrast mediaDigital subtraction angiographyFemaleHepatic veinsHumansHypertension, portalIdiopathic portal hypertensionIodineLiverLiver cirrhosisMaleMiddle agedPhlebographyPortal thrombosisPredictive value of testsPropranoloRiskSplanchnic haemodynamicSplanchnic haemodynamicsVariceal hemorrhageVenous-pressure gradient

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Gut due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2000, it was in position 4/44, thus managing to position itself as a Q1 (Primer Cuartil), in the category Gastroenterology & Hepatology.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 7.38, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jun 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-06-09, the following number of citations:

  • WoS: 32
  • Scopus: 41
  • Europe PMC: 25
  • OpenCitations: 44

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-06-09:

  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 23 (PlumX).

Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Debernardi-Venon, W) and Last Author (Bosch Genover, Jaume).

the author responsible for correspondence tasks has been Bosch Genover, Jaume.