Department of Hepatobiliary Surgery, First Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an Shaanxi Province, China ; XJTU Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an Shaanxi Province, China.
PLoS One. 2013 Sep 30;8(9):e76873. doi: 10.1371/journal.pone.0076873. eCollection 2013.
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.
A 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.
5-7 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.
Magnamosis via a device of novel design was successfully used to establish a portacaval shunt in dogs.
经颈静脉肝内门体分流术治疗门静脉高压症相对安全，但并发症发生率仍较高。为探索一种新的门腔分流术方法，我们将磁压缩技术引入分流术中。
采用 2 对具有血液相容性的钕铁硼永磁体（子母磁体）对 6 只雄性杂种犬行门静脉-下腔静脉分流术。母磁体经股静脉导入导管置于下腔静脉，子磁体通过脾静脉导入球囊导管至门静脉吻合口处。当子磁体到达目标位置后，子母磁体相互吸引，压迫血管壁并保持在原位。5-7 天后，在 X 线引导下，用罗氏-乌奇达经颈静脉肝内穿刺套件将磁体从血管壁上分离。术后 1 个月，行组织学分析和门静脉造影检查。
首次手术后 5-7 天，门静脉和下腔静脉均可见轻度内膜增生，门静脉和下腔静脉的血管外膜连续。第二次手术时，可见对比剂从门静脉流入下腔静脉。术后 1 个月行门静脉造影显示门腔分流仍然存在。
采用新型装置的磁压迫术成功地在犬体内建立了门腔分流。
