Vasopressin perfusion of esophageal varices in cirrhotic patients: cineangiographic study.

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Abstract
Portal cineangiography after umbilicoportal cannulation was used to evaluate esophageal vein perfusion and diameter in 13 cirrhotic patients with severe portal hypertension, prior to and during i.v. vasopressin infusion (0.35 IU/min). Between the 15th and the 20th minute of infusion no change had occurred in the diameters of left gastric veins, esophageal varices, portal veins or splenic veins. Considerable reduction in the left gastric vein perfusion was indirectly documented by prolongation of washout time (> +145%) and increase in vascular density. These modifications were disproportionate in relation to the simultaneous changes in portal pressure (-16%). These results demonstrate that during vasopressin infusion: there is no constriction of the varices at the level of the lower esophageal sphincter; there is a marked decrease in the perfusion of left gastric vein and esophageal varices; and there is a moderate portal pressure decrease which, by itself, may not be a reliable index of the splanchnic hemodynamic response to vasopressin in cirrhotic patients.