Preliminary experience with transluminal laser-induced intrahepatic portacaval shunts.
This study investigated the feasibility of performing an intrahepatic portacaval shunt (IHPCS) by means of transluminal laser angioplasty. In 10 anesthized dogs, a catheter was introduced into a mesenteric vein and threaded into the portal vein (PV). Under fluoroscopy, a Ross needle was passed through the PV catheter, liver, and into the intrahepatic IVC. Following guidewire exchange, a neodymium YAG laser hot-tip probe (power setting 8 W) was passed over the guidewire to accomplish a transluminal IHPCS. In five animals, an IHPCS could not be accomplished. Initial and subsequent patency was confirmed by fluoroscopy. These early data suggest that transvenous laser-induced intrahepatic portacaval shunts may be feasible as a means of decompressing portal hypertension. Further research is necessary, to investigate the long-term patency as well as this technique's ability to decompress the portal system.
Cikrit
D F
DF
Department of Surgery, Indiana University Medical Center, Indianapolis 46202.
Wadley
J J
JJ
Harl
M J
MJ
Heller
S A
SA
Dalsing
M C
MC
D000538:Aluminum Silicates; D016342:Angioplasty, Laser / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D000818:Animals; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D004285:Dogs; D017075:Laser Coagulation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D008099:Liver / Q000098:blood supply; D009339:Needles; D009354:Neodymium; D011167:Portacaval Shunt, Surgical / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D011169:Portal Vein / Q000473:pathology / Q000601:surgery; D011677:Punctures / Q000009:adverse effects; D015642:Radiology, Interventional; D013927:Thrombosis / Q000209:etiology; D014682:Vena Cava, Inferior / Q000473:pathology / Q000601:surgery; D015019:Yttrium
D000538:Aluminum Silicates; D009354:Neodymium; D015019:Yttrium