Transjugular intrahepatic portosystemic shunt with silicone-covered wallstents

Results in a swine model

Hirohiko Tanihata, Richard R. Saxon, Yasushi Kubota, Dusan Pavcnik, Barry Uchida, Josef Rosch, Frederick Keller, Ryusaku Yamada, Morio Sato

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

PURPOSE: To evaluate the use of impermeable silicone-covered Wallstents for trans jugular intrahepatic portosystemic shunt creation. MATERIALS AND METHODS: A transjugular intrahepatic portosystemic shunt was created in 14 young swine (weight, 20-32 kg) by using impermeable silicone-covered Wallstents. In eight animals, the silicone covering extended from the portal vein to the inferior vena cava. In two swine, the silicone covering ended short of the inferior vena cava, in two it ended short of the portal vein wall, and in two it ended short at each end. Follow-up transhepatic portal venography was performed weekly for 6 weeks or until the shunt was occluded. Animals were then sacrificed for gross and histologic evaluation. RESULTS: Only two of 14 shunts were patent after 3 weeks; both were stenosed with luminal narrowing of more than 50% in the middle of the shunt. By 6 weeks, all shunts were occluded. At histologic evaluation, a marked foreign-body reaction with superimposed thrombosis was demonstrated. CONCLUSION: In comparison with uncovered Wallstents, impermeable silicone-covered Wallstents are associated with decreased patency at transjugular intrahepatic portosystemic shunt creation. This is likely due to increased thrombogenicity and a foreign-body reaction.

Original languageEnglish (US)
Pages (from-to)181-184
Number of pages4
JournalRadiology
Volume205
Issue number1
StatePublished - Oct 1997

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Transjugular Intrahepatic Portasystemic Shunt
Silicones
Swine
Foreign-Body Reaction
Inferior Vena Cava
Portal Vein
Surgical Portasystemic Shunt
Phlebography
Thrombosis
Neck
Weights and Measures

Keywords

  • Liver, interventional procedure
  • Shunts, portosystemic
  • Stents and prostheses

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Tanihata, H., Saxon, R. R., Kubota, Y., Pavcnik, D., Uchida, B., Rosch, J., ... Sato, M. (1997). Transjugular intrahepatic portosystemic shunt with silicone-covered wallstents: Results in a swine model. Radiology, 205(1), 181-184.

Transjugular intrahepatic portosystemic shunt with silicone-covered wallstents : Results in a swine model. / Tanihata, Hirohiko; Saxon, Richard R.; Kubota, Yasushi; Pavcnik, Dusan; Uchida, Barry; Rosch, Josef; Keller, Frederick; Yamada, Ryusaku; Sato, Morio.

In: Radiology, Vol. 205, No. 1, 10.1997, p. 181-184.

Research output: Contribution to journalArticle

Tanihata, H, Saxon, RR, Kubota, Y, Pavcnik, D, Uchida, B, Rosch, J, Keller, F, Yamada, R & Sato, M 1997, 'Transjugular intrahepatic portosystemic shunt with silicone-covered wallstents: Results in a swine model', Radiology, vol. 205, no. 1, pp. 181-184.
Tanihata H, Saxon RR, Kubota Y, Pavcnik D, Uchida B, Rosch J et al. Transjugular intrahepatic portosystemic shunt with silicone-covered wallstents: Results in a swine model. Radiology. 1997 Oct;205(1):181-184.
Tanihata, Hirohiko ; Saxon, Richard R. ; Kubota, Yasushi ; Pavcnik, Dusan ; Uchida, Barry ; Rosch, Josef ; Keller, Frederick ; Yamada, Ryusaku ; Sato, Morio. / Transjugular intrahepatic portosystemic shunt with silicone-covered wallstents : Results in a swine model. In: Radiology. 1997 ; Vol. 205, No. 1. pp. 181-184.
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AB - PURPOSE: To evaluate the use of impermeable silicone-covered Wallstents for trans jugular intrahepatic portosystemic shunt creation. MATERIALS AND METHODS: A transjugular intrahepatic portosystemic shunt was created in 14 young swine (weight, 20-32 kg) by using impermeable silicone-covered Wallstents. In eight animals, the silicone covering extended from the portal vein to the inferior vena cava. In two swine, the silicone covering ended short of the inferior vena cava, in two it ended short of the portal vein wall, and in two it ended short at each end. Follow-up transhepatic portal venography was performed weekly for 6 weeks or until the shunt was occluded. Animals were then sacrificed for gross and histologic evaluation. RESULTS: Only two of 14 shunts were patent after 3 weeks; both were stenosed with luminal narrowing of more than 50% in the middle of the shunt. By 6 weeks, all shunts were occluded. At histologic evaluation, a marked foreign-body reaction with superimposed thrombosis was demonstrated. CONCLUSION: In comparison with uncovered Wallstents, impermeable silicone-covered Wallstents are associated with decreased patency at transjugular intrahepatic portosystemic shunt creation. This is likely due to increased thrombogenicity and a foreign-body reaction.

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