Percutaneous control of a portacaval H-graft: description of a new device and its initial clinical application.

Smith, R C; Brown, A R; Spencer, P C; Gill, R W; Griffiths, K A; Lane, R J; Reeve, T S · World J Surg · 1990

case_report · Level V

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Abstract

A percutaneously-controlled inflatable cuff which can change the diameter of a portacaval H-graft has been developed and used in 10 patients. When inflated, the cuff narrows the H-graft to increase portal pressure and reduce shunting. Use of the cuff has been of clinical significance in 3 of 7 long-term surviving patients. Narrowing the shunt improved the clinical state in 2 patients with encephalopathy, and reopening a closed shunt improved ascites in the third patient. Duplex ultrasound and deep Doppler have demonstrated an alteration of hepatic portal blood flow following inflation of the cuff after 6 months. It is concluded that further development of this controlled portacaval H-graft is warranted.

Medical subject headings