Preliminary experience with transluminal laser-induced intrahepatic portacaval shunts

Lasers Surg Med. 1993;13(2):211-8. doi: 10.1002/lsm.1900130209.

Abstract

This study investigated the feasibility of performing an intrahepatic portacaval shunt (IHPCS) by means of transluminal laser angioplasty. In 10 anesthized dogs, a catheter was introduced into a mesenteric vein and threaded into the portal vein (PV). Under fluoroscopy, a Ross needle was passed through the PV catheter, liver, and into the intrahepatic IVC. Following guidewire exchange, a neodymium YAG laser hot-tip probe (power setting 8 W) was passed over the guidewire to accomplish a transluminal IHPCS. In five animals, an IHPCS could not be accomplished. Initial and subsequent patency was confirmed by fluoroscopy. These early data suggest that transvenous laser-induced intrahepatic portacaval shunts may be feasible as a means of decompressing portal hypertension. Further research is necessary, to investigate the long-term patency as well as this technique's ability to decompress the portal system.

MeSH terms

  • Aluminum Silicates
  • Angioplasty, Laser / adverse effects
  • Angioplasty, Laser / instrumentation
  • Angioplasty, Laser / methods*
  • Animals
  • Catheterization / adverse effects
  • Catheterization / instrumentation
  • Catheterization / methods
  • Dogs
  • Laser Coagulation / adverse effects
  • Laser Coagulation / instrumentation
  • Laser Coagulation / methods
  • Liver / blood supply
  • Needles
  • Neodymium
  • Portacaval Shunt, Surgical / adverse effects
  • Portacaval Shunt, Surgical / instrumentation
  • Portacaval Shunt, Surgical / methods*
  • Portal Vein / pathology
  • Portal Vein / surgery
  • Punctures / adverse effects
  • Radiology, Interventional
  • Thrombosis / etiology
  • Vena Cava, Inferior / pathology
  • Vena Cava, Inferior / surgery
  • Yttrium

Substances

  • Aluminum Silicates
  • Neodymium
  • Yttrium