title: Percutaneous retroperitoneal splenorenal shunt: an experimental study in swine.
abstract: OBJECTIVE
  To evaluate the technical possibility of creating a percutaneous retroperitoneal splenorenal shunt (PRESS) in swine as a minimally invasive treatment of portal hypertension.
  
  
  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 retroperitoneal 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.
  
  
  CONCLUSIONS
  Creation of a PRESS is technically possible, and further experimental studies of its efficacy are warranted.
authors.affiliation: Dotter Interventional Institute, Oregon Health Sciences University, Portland, USA.
authors.forename: T
authors.initials: T
authors.lastname: Kaminou
authors.forename: J
authors.initials: J
authors.lastname: Rösch
authors.forename: R
authors.initials: R
authors.lastname: Yamada
authors.forename: B T
authors.initials: BT
authors.lastname: Uchida
authors.forename: D
authors.initials: D
authors.lastname: Pavcnik
authors.forename: H A
authors.initials: HA
authors.lastname: Timmermans
authors.forename: S
authors.initials: S
authors.lastname: Sakaguchi
authors.forename: F S
authors.initials: FS
authors.lastname: Keller
mesh_terms: D000818:Animals; D005240:Feasibility Studies; D006975:Hypertension, Portal / Q000601:surgery*; D015641:Radiography, Interventional; D012187:Retroperitoneal Space; D013164:Splenorenal Shunt, Surgical / Q000379:methods*; D015607:Stents; D013552:Swine