Angiographic assessment of peritoneovenous shunt malfunction.

On 12 patients with reaccumulation of ascitic fluid after peritoneovenous (LeVeen) shunt insertion, shuntograms were performed by direct percutaneous puncture of the venous limb of the shunt. Shunt function was evaluated by pressure determination and injection of sterile iodinated contrast material. The shuntogram correctly predicted the cause of shunt malfunction in ten of 12 patients. Two failures were attributable to central venous hypertension. The addition of pressure measurements has been shown to correlate with central venous pressure at the time of surgery and hopefully will eliminate the inability of the procedure to diagnose shunt malfunction secondary to venous hypertension. There have been no episodes of pulmonary embolization is a safe and effective method for assessing peritoneovenous shunt malfunction. The information gained from this procedure is valuable to the surgeon who plans an operation to correct shunt malfunction.