Percutaneous retroperitoneal splenorenal shunt: an experimental study in swine.
Percutaneous retroperitoneal splenorenal shunt: an experimental study in swine.
复制标题
经皮腹膜后脾肾分流术：猪的实验研究。
DOI：
10.1148/radiology.206.3.9494504
复制
发表时间：
1998
期刊：
影响因子：
19.7
通讯作者：
F. Keller
中科院分区：
文献类型：
--
作者：
T. Kaminou;J. Rösch*;R. Yamada;B. Uchida;D. Pavčnik;H. Timmermans;S. Sakaguchi;F. Keller
目的
评价在猪体内建立经皮腹膜后脾肾分流术（PRESS）作为门静脉高压症微创治疗的技术可能性。
材料和方法
5只正常家猪接受PRESS的创建。将改良的经颈静脉肝内门体分流穿刺套件从右股静脉引入左肾静脉。经腹膜后腔穿刺近端脾静脉。然后放置非覆膜金属支架连接两条静脉。在手术后1小时，进行随访脾静脉造影和尸检后处死动物。
结果
所有病例均成功完成脾静脉穿刺和支架置入。在5例病例中的4例中，脾静脉造影显示在创建PRESS后1小时通过分流道从脾静脉到左肾静脉的血流良好，并且没有泄漏的证据。未观察到生命体征变化。尸检时，观察到沿支架沿着的腹膜后小血肿和极轻微的腹膜内出血。在所有动物的腹膜后腔中发现支架连接两条静脉。
结论
创建PRESS在技术上是可能的，其有效性的进一步实验研究是必要的。
PURPOSE
To evaluate the technical possibility of creating a percutaneous retroperitoneal splenorenal shunt (PRESS) in swine as a minimally invasive treatment of portal hypertension.
MATERIALS AND METHODS
Five normal domestic swine underwent creation of a PRESS. A modified transjugular intrahepatic portosystemic shunt puncture set was introduced from the right femoral vein into the left renal vein. The proximal splenic vein was punctured transvenously through the retroperitoneal cavity. Noncovered metallic stents were then placed to connect both veins. The animals were sacrificed 1 hour after the procedure, after follow-up splenic venography and necropsy were performed.
RESULTS
Puncture of the splenic vein and stent placement were successfully completed in all cases. In four of five cases, the splenic venogram revealed good flow from the splenic vein to the left renal vein through the shunt track 1 hour after creation of the PRESS, and there was no evidence of leakage. No changes in vital signs were noticed. At necropsy, a small retroperitoneal hematoma along the stent and minimal intraperitoneal bleeding were observed. The stents were found in the retroperitoneal cavity connecting both veins in all animals.
CONCLUSION
Creation of a PRESS is technically possible, and further experimental studies of its efficacy are warranted.