title: Feasibility of externalized peritoneovenous shunt (EPVS) for malignant ascites.
abstract: OBJECTIVE
  To evaluate a new modified peritoneovenous shunt therapy, the externalized peritoneovenous shunt (EPVS) system placement, used to treat patients with malignant ascites.
  
  
  METHODS
  We retrospectively reviewed 10 patients, who were not suited for conventional peritoneovenous shunts (PVS), with malignant ascites, which was refractory to medical therapies. Patient characteristics, technical success, efficacy, duration of EPVS placement, adverse events, and outcome were evaluated. Clinical efficacy of the EPVS was evaluated by the change in subjective symptoms.
  
  
  RESULTS
  The primary reasons for applying EPVS were severe anasarca in 4 patients, potential PVS dysfunction in 3 patients, poor performance status in 2 patients, and a history of PVS occlusion in 1 patient. EPVS was successfully placed in all patients, and it provided clinical efficacy in 8 patients (80%). Early death occurred within 7 days after EPVS placement in 2 patients because of renal failure. The median duration of EPVS placement was 10.4 days (range, 2-28 days). In 6 patients (60%), the EPVS was exchanged to conventional PVS sequentially, since the initial EPVS placement resulted in an improvement of the subjective symptoms of the patients, without serious complications.
  
  
  CONCLUSIONS
  EPVS placement may be an option for patients with malignant ascites who may not be appropriate for conventional PVS placement.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Gunma University Hospital, Maebashi, Gunma, Japan. tokue@s2.dion.ne.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tokue
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Takeuchi
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Arai
authors.forename: Keitaro
authors.initials: K
authors.lastname: Sofue
authors.forename: Noriaki
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tsushima
authors.forename: Keigo
authors.initials: K
authors.lastname: Endo
mesh_terms: D000328:Adult; D000368:Aged; D001201:Ascites / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010534:Peritoneal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D010536:Peritoneovenous Shunt / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult