Abstract
Background and AimsInstalling the transjugular intrahepatic portosystemic shunt for portal hypertension is relatively safe, but complications are still high. To explore a new method of portacaval shunt, the magnetic compression technique was introduced into the shunting procedure.MethodsA portal-inferior vena cava shunt was performed on 6 male mongrel dogs by two hemocompatible Nd-Fe-B permanent magnets, parent and daughter. The parent magnet was applied to the inferior vena cava guided by a catheter through the femoral vein. The daughter magnet was moved to the anastomosis position on the portal vein with a balloon catheter through the splenic vein. After the daughter magnet reached the target position, the two magnets acted to compress the vessel wall and hold it in place. Five to 7 days later, under X-ray guidance, the magnets were detached from the vessel wall with a rosch-uchida transjugular liver access set. One month later, histological analysis and portal venography were performed.Results5-7 days after the first surgery, a mild intimal hyperplasia in the portal vein and the inferior vena cava, and continuity of the vascular adventitia from the portal vein to the inferior vena cava as observed. During the second surgery, the contrast media could be observed flowing from the portal vein into the inferior vena cava. Portal venography revealed that the portosystemic shunt was still present one month after the second surgery.ConclusionsMagnamosis via a device of novel design was successfully used to establish a portacaval shunt in dogs.
Highlights
Portal hypertension, the most common complication of cirrhosis, is defined as portal vein pressures exceeding 5 mm Hg or portal vein to hepatic vein gradient of greater than 10 mm Hg
Transjugular intrahepatic portosystemic shunt (TIPS) is considered a standard treatment for complications related to portal hypertension, including variceal bleeding [3]
In the present study we described magnamosis with a novel device for establishing a portacaval shunt in dogs
Summary
The most common complication of cirrhosis, is defined as portal vein pressures exceeding 5 mm Hg or portal vein to hepatic vein gradient of greater than 10 mm Hg. Decompression of varices can be achieved with surgical shunts including portacaval shunt, and a number of randomized studies comparing different surgical shunts in patients have been published. Transjugular intrahepatic portosystemic shunt (TIPS) is considered a standard treatment for complications related to portal hypertension, including variceal bleeding [3]. All types of surgical shunts prevented rebleeding in >90% of patients. These surgeries share several shortcomings, for example, complicated microsurgery, restenosis of the shunt etc. Installing the transjugular intrahepatic portosystemic shunt for portal hypertension is relatively safe, but complications are still high. To explore a new method of portacaval shunt, the magnetic compression technique was introduced into the shunting procedure
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