Portal pressure measurements

These are a measurement taken between the portal vein and Inferior Vena Cava (IVC) representing the liver’s portal pressure.

Portal pressure measurements are taken in order to diagnose and monitor treatment of increased portal pressures caused by liver disease. High portal pressures happen because liver disease can cause increased resistance to blood flow through the liver. Because of this increase in resistance to blood flow, your body makes alternative channels for the blood. Some of these new channels can happen in the oesophagus and/or stomach as ‘varices’ and can cause bleeding, which may be a cause of blood loss (for example, vomiting blood).

The doctors in charge of your case want to diagnose, rule out or monitor certain liver conditions.

The consultant in charge of your case, and the Interventional Radiologist (the doctor who specialises in Imaging Procedures) who will be carrying out the portal pressures measurements will have discussed the situation, and feel that this is the best option for you. However, you will also have the opportunity for your opinion to be taken into account and if, after discussion with your doctors, you do not want the procedure carried out, you can then decide against it.

A specialist doctor called an Interventional Radiologist. Interventional Radiologists are experts in using X-ray equipment and in microsurgical techniques.

In the Imaging Department, in a special Interventional Radiology (IR) Procedure Room which is designed for these specialised procedures. You will be checked into the department by a nurse, who will ask some medical questions and fill out some paperwork. The Interventional Radiologist will then talk to you about the procedure. You will have the opportunity to ask any questions or raise any concerns. Only if you are happy to continue with the procedure will you be asked to sign the consent form.

It is performed in the IR procedure room. You will lie on a special x-ray table on your back and be covered with sterile drapes.

• Your neck area will be cleaned with an antiseptic solution. Local anaesthetic will be injected to numb the area and stop you feeling pain.
• When the neck is numb, a plastic tube is placed into the vein in your neck which will stay there for the whole of the procedure.
• Then a thin tube (catheter) is positioned into the vein using x-ray guidance. Contrast medium (x-ray dye) is injected into the catheter and viewed on an x-ray screen. This confirms that it is in the right position.
• Then when the catheter is in the right position the radiologist will attach a special tube to the catheter which will be attached to the blood pressure machine in order to take the measurements.
• Once all the measurements have been taken the radiologist removes the thin plastic tube in your vein and the catheter and will press gently on the entry site. This prevents bleeding. The procedure usually takes around one hour.