Tanihata H, Saxon R R, Kubota Y, Pavcnik D, Uchida B T, Rosch J, Keller F S, Yamada R, Sato M
Dotter Interventional Institute, Oregon Health Sciences University, Portland, USA.
Radiology. 1997 Oct;205(1):181-4. doi: 10.1148/radiology.205.1.9314982.
To evaluate the use of impermeable silicone-covered Wallstents for transjugular intrahepatic portosystemic shunt creation.
A transjugular intrahepatic portosystemic shunt was created in 14 young swine (weight, 20-32 kg) by using impermeable silicone-covered Wallstents. In eight animals, the silicone covering extended from the portal vein to the inferior vena cava. In two swine, the silicone covering ended short of the inferior vena cava, in two it ended short of the portal vein wall, and in two it ended short at each end. Follow-up transhepatic portal venography was performed weekly for 6 weeks or until the shunt was occluded. Animals were then sacrificed for gross and histologic evaluation.
Only two of 14 shunts were patent after 3 weeks; both were stenosed with luminal narrowing of more than 50% in the middle of the shunt. By 6 weeks, all shunts were occluded. At histologic evaluation, a marked foreign-body reaction with superimposed thrombosis was demonstrated.
In comparison with uncovered Wallstents, impermeable silicone-covered Wallstents are associated with decreased patency at transjugular intrahepatic portosystemic shunt creation. This is likely due to increased thrombogenicity and a foreign-body reaction.
评估使用不透水硅胶覆盖的Wallstent支架进行经颈静脉肝内门体分流术（TIPS）的效果。
使用不透水硅胶覆盖的Wallstent支架对14只幼年猪（体重20 - 32千克）进行经颈静脉肝内门体分流术。8只动物的硅胶覆盖层从门静脉延伸至下腔静脉。2只猪的硅胶覆盖层在下腔静脉前终止，2只在门静脉壁前终止，2只在两端均提前终止。每周进行一次经肝门静脉造影随访，持续6周或直至分流道闭塞。然后处死动物进行大体和组织学评估。
14个分流道中仅2个在3周后仍保持通畅；两者均出现狭窄，分流道中部管腔狭窄超过50%。到6周时，所有分流道均闭塞。组织学评估显示有明显的异物反应并伴有血栓形成。
与未覆盖的Wallstent支架相比，不透水硅胶覆盖的Wallstent支架在经颈静脉肝内门体分流术创建时通畅率降低。这可能是由于血栓形成增加和异物反应所致。
