Avtor/Urednik | Seong, Chang Kyu; Pavčnik, Dušan; Uchida, Barry T; Anai, Hiroshi; Timmermans, Hans; Niyyati, Mahtab; Corless, Christopher L; Correa, Luiz O; Keller, Frederick S; Rösch, Josef | |
Naslov | Experimental percutaneous extrahepatic portacaval shunt creation by transjugular approach in Swine | |
Tip | članek | |
Vir | Cardiovasc Intervent Radiol | |
Vol. in št. | Letnik 28, št. 5 | |
Leto izdaje | 2005 | |
Obseg | str. 616-23 | |
Jezik | eng | |
Abstrakt | The purpose of the study was to evaluate the feasibility of the creation of a percutaneous extrahepatic portacaval shunt (PEPS) in swine by a transjugular approach and to find a suitable stent-graft to use in PEPS. In 12 swine, the extrahepatic portal vein (PV) was entered from the inferior vena cava (IVC) by a needle system introduced from the transjugular approach. A catheter introduced through the transhepatic approach served as a target. Five types of stent-graft consisting of homemade Z stents and a polytetrafluoethylene cover were explored for PEPS creation. Eight animals had follow-up venograms up to 6 weeks or until the shunt became severely stenotic. Gross and histologic examinations were performed after the final follow-up venography. The PV punctures and stent-graft placement were difficult, but the PEPS was established in all animals. In four animals, the stent-graft failed to adequately cover the tract, causing severe hemorrhage. Only two shunts remained patent up to 6 weeks. The other shunts exhibited severe stenosis or occlusion. At gross examination, all shunts traversed the liver parenchyma of the caudate lobe surrounding the IVC. The extravascular PEPS portion was 4 mm to 2 cm long. All shunts entered the PV close to the splenomesenteric junction and exhibited neointimal formation. Shunt stenoses were caused by neointimal hyperplasia and occlusions by a superimposed thrombus. PEPS can be created by the transjugular approach in swine, but only the PV shunt entrance is extrahepatic. None of the tested rigid stent-grafts were suitable for PEPS creation. A short flexible stent-graft with flanged ends is suggested for further exploration. | |
Deskriptorji | PORTACAVAL SHUNT, SURGICAL ANIMALS DISEASE MODELS, ANIMAL GRAFT OCCLUSION, VASCULAR HEMOPERITONEUM JUGULAR VEINS LIVER MESENTERIC ARTERY, INFERIOR PORTAL VEIN PORTOGRAPHY PROSTHESIS FAILURE STENTS SWINE VASCULAR PATENCY VENA CAVA, INFERIOR |