Expandable intrahepatic portacaval shunt stents: early experience in the dog

Palmaz, Julio C.; Sibbitt, Randy R.; Reuter, Stewart R.; Garcı́a, Francisco; Tio, Fermin O.

doi:10.2214/ajr.145.4.821

Cited by 133 publications

(34 citation statements)

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“…[18][19][20][21][22] This device is a stainless steel tubular mesh expandable graft for supporting vascular walls after balloon dilation. The purposes of this study were (1) to devise a technique for the delivery and placement of these stents in both native pulmonary arteries and systemic veins in experimental animals and (2) to investigate the effects on the intravascular flow and on the vessel wall and surrounding tissue.…”

mentioning

confidence: 99%

Implantation of balloon-expandable intravascular grafts by catheterization in pulmonary arteries and systemic veins.

et al. 1988

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The purpose of this investigation was to evaluate the efficacy and safety of implanting expandable intravascular stents in pulmonary arteries and systemic veins. Twenty-seven balloonexpandable grafts were placed in 13 mongrel dogs under anesthesia. A long sheath was introduced over a wire and catheter or dilator into the pulmonary artery or target vein. A collapsed stainless steel expandable mesh stent was placed over the balloon of an angioplasty catheter. The catheter with the mounted stent was advanced through the sheath. The stent expanded to the diameter of the balloon as the balloon was inflated, and remained expanded as the balloon was deflated. The stent was expanded further with a larger balloon in 11 instances. Eleven stents were placed successfully in pulmonary arteries (out of thirteen attempted), and 1 1 of 14 were installed in tributaries of the precava or postcava. Three inadvertent embolizations of the devices occurred. All three devices that embolized lodged in the pulmonary arteries and did not obstruct flow. Seven dogs were recatheterized at intervals ranging from 56 to 278 days. Twelve stents were patent and nonobstructive, and two were malpositioned, one of which was obstructed. Three animals were killed 2 months (two dogs) and 9 months (one dog) after the implantations. The stents (four in the pulmonary arteries and two in veins) were completely covered with neointima and were patent, without thrombosis. These stents hold promise for definitive dilation of congenital or postoperative vessel stenoses.

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mentioning

confidence: 99%

Implantation of balloon-expandable intravascular grafts by catheterization in pulmonary arteries and systemic veins.

et al. 1988

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“…In addition to the original Palmaz and Wall stents, there is the Strecker stent and the Memotherm stent (Angiomed, Karlsruhe, Germany). Claimed advantages for these new stents are increased radioopacity (Strecker stent) and improved delivery systems (Memo stent) [29].…”

Section: Transjugular Intrahepatic Portosystemic Shunt (Tips)mentioning

confidence: 99%

Egyptian Hepatic Veno-Occlusive Disease: Surgical Point of View

Salama¹

2013

Hepatic Surgery

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“…They used angioplasty balloon catheters and repeated dilation tryi ng to establ ish a large transparenchym al tract While these shunts were effective in lowering portal pressure , they tended to occlude rapidly because of elastic recoils in the adjacent hepatic parenchyma. Plamaz et al (8) in 1985 and Rösch et al (9) in 1987 used expandable metallic vascular stents to creat TIPS in animals and showed the neointimal lining Using balloon -expandable Palmaz stent adaption of the shunt dimension to the individual hemodynamics is easy. That is , redilation and further increase of shunt diameter is simple with the insertion of bigger balloons and also may be performed in a second procedure by transjugular approach.…”

Section: R-mentioning

confidence: 99%

Clinical Results of the Transjugular Intrahepatic Portosystemic Shunt

Kim¹,

Park²,

Sim³

et al. 1994

J Korean Radiol Soc

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Purpose: To evaluate the cilinical results of transjugular intrahepatic portosystemicshunt(TIPS) forthe control ofvariceal bleeding.Materi c: ls and Methods; TIPS creation was attempted in 23 patients with endoscopically confirmed variceal bleeding. Most patients had multiple episodes 。 f bleeding in the past and have been treated with multiple endoscopic sclerotherapies. Pre-and post-procedural hepatic and portal vein pressures were measured. Aftercreation of TIPS patientswere followed up at regular intervals.Results: TIPS has been successfully accomplished in 22 of 23 patients using Wallstent(n = 21) and Strecker stent(n=1 ) . Immediate bleeding control was achieved in all patients with shunt creation. No procedure-related complication was noted. Portal vein pressure was reduced from 30.7 :t 5 .8 mmHg to 20.8 :t 4.7 mmHg. The mean pressure gradient of portosystemic shunt dropped from 22.8 :t 6.0 prior to TIPS to 12.2 :t 4.1 immediately after. During the follow-up period (6-556 days, mean; 10months ), seven patients died; progressive hepatic failure (n=4), variceal rebleeding(n=2 ), and respiratory failure(n=1). Hepatic encephalopathy after TIPS was noted in 7 patients(31.8%). Variceal rebleeding occurred in 3 patients(13.6%). The remaining 15 patients have survived an average of 11 months.Conclusion: This results suggest that TIPS is a safe and effective method for lowering portal pressure and controlling variceal bleeding . Furthermore if these initial results are encourged by further long-term observation, TIPS could replace endoscopic and risky surgical intervention.

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Expandable intrahepatic portacaval shunt stents: early experience in the dog

Cited by 133 publications

References 1 publication

Implantation of balloon-expandable intravascular grafts by catheterization in pulmonary arteries and systemic veins.

Implantation of balloon-expandable intravascular grafts by catheterization in pulmonary arteries and systemic veins.

Egyptian Hepatic Veno-Occlusive Disease: Surgical Point of View

Clinical Results of the Transjugular Intrahepatic Portosystemic Shunt

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