42 research outputs found

    Acute effects of liver vein occlusion by stent-graft placed in transjugular intrahepatic portosystemic shunt channel: An experimental study

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    The purpose of this study was to evaluate the effects of hepatic vein occlusion by stent-graft used in transjugular intrahepatic portosystemic shunt (TIPS). The experiments were performed in six healthy pigs under general anesthesia. Following percutaneous transhepatic implantation of a port-a-cath in the right hepatic vein, TIPS was created with a stent-graft (Viatorr; W L Gore, Flagstaff, AZ, USA). The outflow from the hepatic vein, blocked by the stent-graft was documented by injection of contrast medium and repeated injections of 99Tc(m)-labeled human serum albumin through the port-a-cath. After 2 weeks, the outflow was re-evaluated, the pigs were sacrificed, and histopathologic examination of the liver was performed. Occlusion of the hepatic vein by a stent-graft had a short and temporary effect on the outflow. Histopathological examination from the affected liver segment showed no divergent pattern. Stent-grafts used in TIPS block the outflow from the liver vein, but do not have a prolonged circulatory effect and do not affect the liver parenchyma

    The YAG laser and Wallstent endoprosthesis for palliation of cancer in the esophagus or gastric cardia

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    The need for frequent retreatment is a disadvantage of using endoscopic laser therapy (ELT) alone for palliative treatment of esophageal carcinoma. In this prospective study, therefore, we investigated the potential and feasibility of combining ELT with a self-expanding metallic stent (Wallstent). Twelve patients received ELT followed by stent placement (stent group) and were compared with 39 patients receiving ELT alone (ELT group). Swallowing ability was similar in the two groups. About one-third of the patients who had a short life expectancy, did not appear to benefit from stenting, whereas the interval between retreatments was prolonged by a factor of 2-4 in the remaining patients. Median survivals were 5.5 (range 1.0-23.5) months in patients with stents, and 4.5 (range 1.2-24.6) months in patients without stents. There were few complications related to stenting. In one patient, technical problems caused stent dislodgement into the stomach. Another stent patient died of hemorrhage from an untreated tumor in the stomach, but it was considered unlikely that the bleeding was caused by the stent. In conclusion, this preliminary trial suggests that a Wallstent endoprosthesis, used in combination with laser treatment, may become a valuable tool for prolonging the dysphagia-free interval in selected patients
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