| Bile duct injury as a major cause of stenosis and occlusion in transjugular intrahepatic portosystemic shunts: comparative histopathologic analysis in humans and swine. | |
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MedLine Citation:
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PMID: 8855524 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: A comparative histologic analysis of human and swine transjugular intrahepatic portosystemic shunts (TIPS) was performed to investigate factors limiting TIPS patency and to further develop an animal model for TIPS. MATERIALS AND METHODS: Twenty-one human and 13 porcine shunts were evaluated by means of gross inspection, histologic evaluation, and electron microscopy. RESULTS: Severe stenosis (> 75% narrowing) or occlusion was detected with portal venography in nine of the 21 human shunts (48%) and in 10 of 13 porcine shunts (77%). Gross or histologic evidence of a substantial biliary fistula was observed in seven of nine porcine shunts and in seven of eight human shunts with severe parenchymal tract stenosis or occlusion. No evidence of substantial bile duct injury was identified in the 13 human shunts or two swine shunts with patent, nonstenotic parenchymal tracts (P < .01, Fisher exact). Histologic findings in porcine shunts mimicked human tissue responses, including a metaplastic proliferation of bile duct epithelium at sites of bile duct transection. CONCLUSION: Bile duct transection and bile leak are significantly associated with TIPS parenchymal tract abnormalities in patients and swine. TIPS in swine created with the Wallstent faithfully reproduce gross morphologic and histologic changes observed in patients. |
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Authors:
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R R Saxon; J Mendel-Hartvig; C L Corless; J Rabkin; B T Uchida; K Nishimine; F S Keller |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of vascular and interventional radiology : JVIR Volume: 7 ISSN: 1051-0443 ISO Abbreviation: J Vasc Interv Radiol Publication Date: 1996 Jul-Aug |
Date Detail:
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Created Date: 1996-12-24 Completed Date: 1996-12-24 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9203369 Medline TA: J Vasc Interv Radiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 487-97 Citation Subset: IM |
Affiliation:
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Dotter Interventional Institute, Portland, OR 97201-3098, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Bile Bile Ducts / injuries*, pathology Biliary Fistula / etiology, pathology Constriction, Pathologic / etiology, pathology Disease Models, Animal Epithelium / pathology Female Follow-Up Studies Hepatic Veins / pathology Humans Male Metaplasia Microscopy, Electron Portal Vein / pathology Portasystemic Shunt, Transjugular Intrahepatic / adverse effects* Portography Stents Swine Thrombosis / etiology, pathology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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