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Experimental percutaneous extrahepatic portacaval shunt creation by transjugular approach in Swine
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 cav...
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| Published in: | Cardiovascular and interventional radiology 2005-06, Vol.28 (5), p.616-623 |
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| container_title | Cardiovascular and interventional radiology |
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| creator | Seong, Chang Kyu Pavcnik, Dusan Uchida, Barry T Anai, Hiroshi Timmermans, Hans Niyyati, Mahtab Corless, Christopher L Correa, Luiz O Keller, Frederick S Rösch, Josef |
| description | 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. |
| doi_str_mv | 10.1007/s00270-004-0305-0 |
| format | article |
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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.</description><identifier>ISSN: 0174-1551</identifier><identifier>EISSN: 1432-086X</identifier><identifier>DOI: 10.1007/s00270-004-0305-0</identifier><identifier>PMID: 16059763</identifier><language>eng</language><publisher>United States: Springer Nature B.V</publisher><subject>Animals ; Blood clots ; Blood Vessel Prosthesis Implantation ; BYPASSES ; Clinical trials ; Disease Models, Animal ; Female ; Graft Occlusion, Vascular - diagnostic imaging ; Graft Occlusion, Vascular - etiology ; GRAFTS ; Hemoperitoneum - diagnostic imaging ; Hemoperitoneum - etiology ; HEMORRHAGE ; Jugular Veins - surgery ; LIVER ; Liver - blood supply ; Liver - surgery ; Mesenteric Artery, Inferior - diagnostic imaging ; Mesenteric Artery, Inferior - surgery ; PHOSPHOENOLPYRUVATE ; Portacaval Shunt, Surgical ; Portal Vein - diagnostic imaging ; Portal Vein - surgery ; Portography ; Prosthesis Failure ; RADIOLOGY AND NUCLEAR MEDICINE ; Stents ; SWINE ; Vascular Patency ; VEINS ; Vena Cava, Inferior - diagnostic imaging ; Vena Cava, Inferior - surgery</subject><ispartof>Cardiovascular and interventional radiology, 2005-06, Vol.28 (5), p.616-623</ispartof><rights>Springer Science+Business Media, Inc. 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c387t-5cf6ab0a9fb143c9927ce8ebaf49ee7bfc26fffbe500891270492abfce8229863</citedby><cites>FETCH-LOGICAL-c387t-5cf6ab0a9fb143c9927ce8ebaf49ee7bfc26fffbe500891270492abfce8229863</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,786,790,891,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16059763$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/21091341$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Seong, Chang Kyu</creatorcontrib><creatorcontrib>Pavcnik, Dusan</creatorcontrib><creatorcontrib>Uchida, Barry T</creatorcontrib><creatorcontrib>Anai, Hiroshi</creatorcontrib><creatorcontrib>Timmermans, Hans</creatorcontrib><creatorcontrib>Niyyati, Mahtab</creatorcontrib><creatorcontrib>Corless, Christopher L</creatorcontrib><creatorcontrib>Correa, Luiz O</creatorcontrib><creatorcontrib>Keller, Frederick S</creatorcontrib><creatorcontrib>Rösch, Josef</creatorcontrib><title>Experimental percutaneous extrahepatic portacaval shunt creation by transjugular approach in Swine</title><title>Cardiovascular and interventional radiology</title><addtitle>Cardiovasc Intervent Radiol</addtitle><description>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.</description><subject>Animals</subject><subject>Blood clots</subject><subject>Blood Vessel Prosthesis Implantation</subject><subject>BYPASSES</subject><subject>Clinical trials</subject><subject>Disease Models, Animal</subject><subject>Female</subject><subject>Graft Occlusion, Vascular - diagnostic imaging</subject><subject>Graft Occlusion, Vascular - etiology</subject><subject>GRAFTS</subject><subject>Hemoperitoneum - diagnostic imaging</subject><subject>Hemoperitoneum - etiology</subject><subject>HEMORRHAGE</subject><subject>Jugular Veins - surgery</subject><subject>LIVER</subject><subject>Liver - blood supply</subject><subject>Liver - surgery</subject><subject>Mesenteric Artery, Inferior - diagnostic imaging</subject><subject>Mesenteric Artery, Inferior - surgery</subject><subject>PHOSPHOENOLPYRUVATE</subject><subject>Portacaval Shunt, Surgical</subject><subject>Portal Vein - diagnostic imaging</subject><subject>Portal Vein - surgery</subject><subject>Portography</subject><subject>Prosthesis Failure</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Stents</subject><subject>SWINE</subject><subject>Vascular Patency</subject><subject>VEINS</subject><subject>Vena Cava, Inferior - diagnostic imaging</subject><subject>Vena Cava, Inferior - surgery</subject><issn>0174-1551</issn><issn>1432-086X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><recordid>eNp9kU2LFDEQhoMo7jj6A7xIcEG8tFaSzkcfZdkPYWEPq-AtpGPF6aEn3SZp3f33ZugBwYOXVEieeqm3XkJeM_jAAPTHDMA1NABtAwJkA0_IhrWCN2DUt6dkA0y3DZOSnZEXOe8BmDRcPidnTIHstBIb0l8-zJiGA8biRlqvfiku4rRkig8luR3OrgyezlMqzrtfFcq7JRbqE9aPKdL-kVYu5v3yYxldom6e0-T8jg6R3v8eIr4kz4IbM7461S35enX55eKmub27_nzx6bbxwujSSB-U68F1oa8efNdx7dFg70LbIeo-eK5CCD1KANOxarztuKvPaDjvjBJbcr7qTrkMNvuhoN_5KUb0xXIGHRMtq9S7lapT_lwwF3sYssdxXF1bZRQH1coKvv8vyAwYLeoWj-jbf9D9tKRYzVrNqxxngleIrZBPU84Jg53r3l16tAzsMU67xmlrnPYYZz225M1JeOkP-P1vxyk_8QeEbZwZ</recordid><startdate>200506</startdate><enddate>200506</enddate><creator>Seong, Chang Kyu</creator><creator>Pavcnik, Dusan</creator><creator>Uchida, Barry T</creator><creator>Anai, Hiroshi</creator><creator>Timmermans, Hans</creator><creator>Niyyati, Mahtab</creator><creator>Corless, Christopher L</creator><creator>Correa, Luiz O</creator><creator>Keller, Frederick S</creator><creator>Rösch, Josef</creator><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7U7</scope><scope>C1K</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>200506</creationdate><title>Experimental percutaneous extrahepatic portacaval shunt creation by transjugular approach in Swine</title><author>Seong, Chang Kyu ; Pavcnik, Dusan ; Uchida, Barry T ; Anai, Hiroshi ; Timmermans, Hans ; Niyyati, Mahtab ; Corless, Christopher L ; Correa, Luiz O ; Keller, Frederick S ; Rösch, Josef</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c387t-5cf6ab0a9fb143c9927ce8ebaf49ee7bfc26fffbe500891270492abfce8229863</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Animals</topic><topic>Blood clots</topic><topic>Blood Vessel Prosthesis Implantation</topic><topic>BYPASSES</topic><topic>Clinical trials</topic><topic>Disease Models, Animal</topic><topic>Female</topic><topic>Graft Occlusion, Vascular - diagnostic imaging</topic><topic>Graft Occlusion, Vascular - etiology</topic><topic>GRAFTS</topic><topic>Hemoperitoneum - diagnostic imaging</topic><topic>Hemoperitoneum - etiology</topic><topic>HEMORRHAGE</topic><topic>Jugular Veins - surgery</topic><topic>LIVER</topic><topic>Liver - blood supply</topic><topic>Liver - surgery</topic><topic>Mesenteric Artery, Inferior - diagnostic imaging</topic><topic>Mesenteric Artery, Inferior - surgery</topic><topic>PHOSPHOENOLPYRUVATE</topic><topic>Portacaval Shunt, Surgical</topic><topic>Portal Vein - diagnostic imaging</topic><topic>Portal Vein - surgery</topic><topic>Portography</topic><topic>Prosthesis Failure</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Stents</topic><topic>SWINE</topic><topic>Vascular Patency</topic><topic>VEINS</topic><topic>Vena Cava, Inferior - diagnostic imaging</topic><topic>Vena Cava, Inferior - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Seong, Chang Kyu</creatorcontrib><creatorcontrib>Pavcnik, Dusan</creatorcontrib><creatorcontrib>Uchida, Barry T</creatorcontrib><creatorcontrib>Anai, Hiroshi</creatorcontrib><creatorcontrib>Timmermans, Hans</creatorcontrib><creatorcontrib>Niyyati, Mahtab</creatorcontrib><creatorcontrib>Corless, Christopher L</creatorcontrib><creatorcontrib>Correa, Luiz O</creatorcontrib><creatorcontrib>Keller, Frederick S</creatorcontrib><creatorcontrib>Rösch, Josef</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>Cardiovascular and interventional radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Seong, Chang Kyu</au><au>Pavcnik, Dusan</au><au>Uchida, Barry T</au><au>Anai, Hiroshi</au><au>Timmermans, Hans</au><au>Niyyati, Mahtab</au><au>Corless, Christopher L</au><au>Correa, Luiz O</au><au>Keller, Frederick S</au><au>Rösch, Josef</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Experimental percutaneous extrahepatic portacaval shunt creation by transjugular approach in Swine</atitle><jtitle>Cardiovascular and interventional radiology</jtitle><addtitle>Cardiovasc Intervent Radiol</addtitle><date>2005-06</date><risdate>2005</risdate><volume>28</volume><issue>5</issue><spage>616</spage><epage>623</epage><pages>616-623</pages><issn>0174-1551</issn><eissn>1432-086X</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>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.</abstract><cop>United States</cop><pub>Springer Nature B.V</pub><pmid>16059763</pmid><doi>10.1007/s00270-004-0305-0</doi><tpages>8</tpages></addata></record> |
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| ispartof | Cardiovascular and interventional radiology, 2005-06, Vol.28 (5), p.616-623 |
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| subjects | Animals Blood clots Blood Vessel Prosthesis Implantation BYPASSES Clinical trials Disease Models, Animal Female Graft Occlusion, Vascular - diagnostic imaging Graft Occlusion, Vascular - etiology GRAFTS Hemoperitoneum - diagnostic imaging Hemoperitoneum - etiology HEMORRHAGE Jugular Veins - surgery LIVER Liver - blood supply Liver - surgery Mesenteric Artery, Inferior - diagnostic imaging Mesenteric Artery, Inferior - surgery PHOSPHOENOLPYRUVATE Portacaval Shunt, Surgical Portal Vein - diagnostic imaging Portal Vein - surgery Portography Prosthesis Failure RADIOLOGY AND NUCLEAR MEDICINE Stents SWINE Vascular Patency VEINS Vena Cava, Inferior - diagnostic imaging Vena Cava, Inferior - surgery |
| title | Experimental percutaneous extrahepatic portacaval shunt creation by transjugular approach in Swine |
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