Document Detail


High occlusion rate in experimental transjugular intrahepatic portosystemic shunt created with a Dacron-covered nitinol stent.
MedLine Citation:
PMID:  10082107     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To assess whether the use of a prosthesis covered by a Dacron sheath might prevent pseudointimal hyperplasia in a transjugular intrahepatic portosystemic shunt (TIPS). MATERIALS AND METHODS: A TIPS procedure was performed in nine pigs, after creation of a portal vein microembolization model of portal hypertension, by using a Dacron-covered nitinol stent. The first centimeter on the lower extremity of this specially made prototype was uncovered, to avoid portal vein thrombosis. Three weeks later, the seven surviving animals underwent transjugular hemodynamic and angiographic follow-up and were then killed for gross and histologic evaluation. RESULTS: Shunt insertion was possible in all pigs; two died of complications of the procedure. After 3 weeks only two shunts were patent, although a 50%-60% narrowing of the initial portion of the shunt was present; the remaining shunts were occluded. Histologic examination showed pseudointimal hyperplasia associated, in the cases of occlusion, with a luminal thrombosis. CONCLUSION: This Dacron-covered stent did not prevent pseudointima formation over the stent and resulted in a high early occlusion rate, probably related to a pronounced tissue fibrotic response likely due to Dacron-induced inflammation.
Authors:
P Otal; H Rousseau; J P Vinel; H Ducoin; S Hassissene; F Joffre
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  10     ISSN:  1051-0443     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-04-05     Completed Date:  1999-04-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  183-8     Citation Subset:  IM    
Affiliation:
Department of Radiology, University Hospital of Toulouse Rangueil, Toulouse, France.
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MeSH Terms
Descriptor/Qualifier:
Alloys*
Angiography
Animals
Disease Models, Animal
Embolism / surgery
Equipment Design
Fibrosis
Follow-Up Studies
Graft Occlusion, Vascular / etiology
Hemodynamics / physiology
Hepatic Artery / pathology,  surgery
Hyperplasia
Hypertension, Portal / surgery
Polyethylene Terephthalates*
Portal Vein / pathology,  surgery
Portasystemic Shunt, Transjugular Intrahepatic / adverse effects,  instrumentation*
Stents*
Surface Properties
Survival Rate
Swine
Thrombosis / etiology
Tunica Intima / pathology
Vascular Patency
Chemical
Reg. No./Substance:
0/Alloys; 0/Polyethylene Terephthalates; 52013-44-2/nitinol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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