Expandable intrahepatic portacaval shunt stents: early experience in the dog.

Intrahepatic portacaval shunts were established in dogs by the transjugular approach. The shunts extended from the anterior aspect of the inferior vena cava to the portal bifurcation through interposed liver parenchyma. The tissue track was created by a long transjugular needle and enlarged by balloon angioplasty catheter dilatation. The opening was then stented with a specially made, expandable, tubular, woven mesh of stainless steel wire. The stent was introduced mounted in a collapsed fashion around a folded angioplasty balloon. Inflation of the balloon expanded the stent and the tissue track simultaneously, leaving a large side-to-side portacaval shunt. Nine out of 12 animals survived the procedure and eight of them had functioning shunts as long as 9 months after placement. Pathologic examination showed complete endothelialization of the inner surface of the stents.