TY - JOUR
T1 - Percutaneous retroperitoneal splenorenal shunt
T2 - An experimental study in swine
AU - Kaminou, Toshio
AU - Rösch, Josef
AU - Yamada, Ryusaku
AU - Uchida, Barry T.
AU - Pavcnik, Dusan
AU - Timmermans, Hans A.
AU - Sakaguchi, Shoji
AU - Keller, Frederick S.
PY - 1998/3
Y1 - 1998/3
N2 - PURPOSE: To evaluate the technical possibility of creating a percutaneous retroperitoneal splenorenal shunt (PRESS) in swine as a minimally invasive treatment of portal hypertension. MATERIALS AND METHODS: Five normal domestic swine underwent creation of a PRESS. A modified transjugular intrahepatic portosystemic shunt puncture set was introduced from the right femoral vein into the left renal vein. The proximal splenic vein was punctured transvenously through the retropentoneal cavity. Noncovered metallic stents were then placed to connect both veins. The animals were sacrificed 1 hour after the procedure, after follow-up splenic venography and necropsy were performed. RESULTS: Puncture of the splenic vein and stent placement were successfully completed in all cases. In four of five cases, the splenic venogram revealed good flow from the splenic vein to the left renal vein through the shunt track 1 hour after creation of the PRESS, and there was no evidence of leakage. No changes in vital signs were noticed. At necropsy, a small retroperitoneal hematoma along the stent and minimal intraperitoneal bleeding were observed. The stents were found in the retroperitoneal cavity connecting both veins in all animals. CONCLUSION: Creation of a PRESs is technically possible, and further experimental studies of its efficacy are warranted.
AB - PURPOSE: To evaluate the technical possibility of creating a percutaneous retroperitoneal splenorenal shunt (PRESS) in swine as a minimally invasive treatment of portal hypertension. MATERIALS AND METHODS: Five normal domestic swine underwent creation of a PRESS. A modified transjugular intrahepatic portosystemic shunt puncture set was introduced from the right femoral vein into the left renal vein. The proximal splenic vein was punctured transvenously through the retropentoneal cavity. Noncovered metallic stents were then placed to connect both veins. The animals were sacrificed 1 hour after the procedure, after follow-up splenic venography and necropsy were performed. RESULTS: Puncture of the splenic vein and stent placement were successfully completed in all cases. In four of five cases, the splenic venogram revealed good flow from the splenic vein to the left renal vein through the shunt track 1 hour after creation of the PRESS, and there was no evidence of leakage. No changes in vital signs were noticed. At necropsy, a small retroperitoneal hematoma along the stent and minimal intraperitoneal bleeding were observed. The stents were found in the retroperitoneal cavity connecting both veins in all animals. CONCLUSION: Creation of a PRESs is technically possible, and further experimental studies of its efficacy are warranted.
KW - Hypertension, portal
KW - Interventional procedures, experimental
KW - Shunts, splenorenal
KW - Stents and protheses
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U2 - 10.1148/radiology.206.3.9494504
DO - 10.1148/radiology.206.3.9494504
M3 - Article
C2 - 9494504
AN - SCOPUS:2642639610
SN - 0033-8419
VL - 206
SP - 799
EP - 802
JO - RADIOLOGY
JF - RADIOLOGY
IS - 3
ER -