Cellophane banding for the gradual attenuation of single extrahepatic portosystemic shunts in eleven dogs

Abstract

Cellophane banding is simple to perform, and causes progressive attenuation of single extrahepatic shunts in dogs. Further work is needed to determine the maximum diameter of a cellophane band which will produce total attenuation, and the long-term safety and reliability of the treatment.

Outcomes of Cellophane Banding for Congenital Portosystemic Shunts in 106 Dogs and 5 Cats

“…13,14 Two methods of slow occlusion using extravascular techniques have been reported: the ameroid constrictor (ameroid ring) [2][3][4][7][8][9]11,12 and cellophane bands. 1,5,10 Results of ameroid constrictor application have been encouraging, although a high incidence of multiple acquired shunts has been identified in published studies and anecdotally ( RM Bright, personal communication, 2000).…”

“…5 Briefly, a strip of cellophane (10 cm long, 1.2 cm wide), was folded longitudinally to form a 3-layered strip (10 cm long, approximately 4 mm wide). The strip was passed around the shunt and tightened around both the shunt and a stainless steel pin of pre-determined size, using one or more titanium clips.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12] The rationale for slow attenuation is manifold, including reduced risk of life-threatening portal hypertension, speculation that slow occlusion may reduce the risk of post-ligation neurologic dysfunction, reduced operating time, less extensive intraoperative monitoring, and the fact that animals undergoing complete shunt occlusion have a better long-term prognosis than those undergoing partial attenuation only. 13,14 Two methods of slow occlusion using extravascular techniques have been reported: the ameroid constrictor (ameroid ring) [2][3][4][7][8][9]11,12 and cellophane bands.…”

Prognostic Implications of the Degree of Shunt Narrowing and of the Portal Vein Diameter in Dogs with Congenital Portosystemic Shunts

“…[3][4][5][6][7] An alternative method is to use surgical techniques that achieve gradual progressive closure of the CPS such as perivascular ameroid constrictors, cellophane banding, and intravascular thrombogenic coils. [8][9][10][11][12][13][14][15] The prognosis after surgical intervention remains unpredictable and recurrence or persistence of clinical disease has been documented with all techniques used for shunt attenuation. 2,6,[8][9][10]12,[14][15][16] Poorly developed portal vasculature cranial to the CPS and the degree of shunt closure have been reported to determine clinical outcome after partial shunt ligation.…”

“…[8][9][10][11][12][13][14][15] The prognosis after surgical intervention remains unpredictable and recurrence or persistence of clinical disease has been documented with all techniques used for shunt attenuation. 2,6,[8][9][10]12,[14][15][16] Poorly developed portal vasculature cranial to the CPS and the degree of shunt closure have been reported to determine clinical outcome after partial shunt ligation. 2,6,17 However, not all previous reports have confirmed a relationship between degree of closure and outcome.…”