Percutaneous control of a portacaval H-graft: description of a new device and its initial clinical application.
A percutaneously-controlled inflatable cuff which can change the diameter of a portacaval H-graft has been developed and used in 10 patients. When inflated, the cuff narrows the H-graft to increase portal pressure and reduce shunting. Use of the cuff has been of clinical significance in 3 of 7 long-term surviving patients. Narrowing the shunt improved the clinical state in 2 patients with encephalopathy, and reopening a closed shunt improved ascites in the third patient. Duplex ultrasound and deep Doppler have demonstrated an alteration of hepatic portal blood flow following inflation of the cuff after 6 months. It is concluded that further development of this controlled portacaval H-graft is warranted.
Smith
R C
RC
Department of Surgery, University of Sydney, Royal North Shore Hospital, Australia.
Brown
A R
AR
Spencer
P C
PC
Gill
R W
RW
Griffiths
K A
KA
Lane
R J
RJ
Reeve
T S
TS
D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D006501:Hepatic Encephalopathy / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011170:Portasystemic Shunt, Surgical / Q000295:instrumentation* / Q000379:methods
D011138:Polytetrafluoroethylene