ABSTRACT
Native "Vitaflon" vascular graft made of spongeous polytetrafluoroethylene for portocaval shunt was evaluated in patients with portal hypertension. Experimental series in grey rabbits proved high biological inertness of the graft. It was used for portocaval shunt in 13 patients. The follow-up from 1 to 32 months demonstrated successful results in 12 cases.
Subject(s)
Biocompatible Materials , Blood Vessel Prosthesis Implantation/instrumentation , Blood Vessel Prosthesis , Polytetrafluoroethylene , Portasystemic Shunt, Surgical , Animals , Evaluation Studies as Topic , Female , Humans , Hypertension, Portal/surgery , Prosthesis Design , Rabbits , Treatment OutcomeSubject(s)
Esophageal and Gastric Varices/therapy , Gastrointestinal Hemorrhage/therapy , Hypertension, Portal/therapy , Acute Disease , Adolescent , Adult , Aged , Combined Modality Therapy , Drug Therapy, Combination , Endoscopy, Digestive System , Esophageal and Gastric Varices/diagnosis , Esophageal and Gastric Varices/etiology , Female , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/etiology , Hemostasis, Endoscopic/instrumentation , Hemostasis, Endoscopic/methods , Hemostatics/administration & dosage , Humans , Hypertension, Portal/complications , Hypertension, Portal/diagnosis , Male , Middle Aged , Nitroglycerin/administration & dosage , Plasma , RecurrenceABSTRACT
After studying the results of embolization of the hepatic artery in 14 patients with portal hypertension and resistant ascites the authors came to the conclusion that this operation often leads to the development of hepatic insufficiency and a fatal outcome and produces a clinical effect only in a small number of patients. Celiac- and mesenteric angiography and transhepatic portography were carried out for pathogenetic substantiation of the intervention. Pressure in the portal vein, hepatic veins and arteries, and in the inferior vena cava was measured during the examination. The space velocity of the portal and arterial hepatic blood flow was determined. Clinico-angiographic examination of the patients failed to reveal criteria for predicting the efficacy of embolization of the hepatic artery. A positive result may be expected in cases in which embolization leads to a reduction in portal pressure. Embolization of the hepatic artery produced no clinical effect in initial reduction of the blood flow in the liver.
Subject(s)
Ascites/etiology , Embolization, Therapeutic , Hepatic Artery , Hypertension, Portal/therapy , Adult , Angiography , Ascites/therapy , Blood Pressure , Celiac Artery/diagnostic imaging , Female , Hepatic Artery/diagnostic imaging , Humans , Hypertension, Portal/complications , Hypertension, Portal/diagnostic imaging , Male , Mesenteric Arteries/diagnostic imaging , PrognosisABSTRACT
Experience in 100 operations for the creation of a peritoneovenous shunt in 63 patients with portal hypertension and resistant ascites showed that in careful selection of patients and determination of contraindications this operation is an effective method for the treatment of resistant ascites in patients with portal hypertension. The shunt increases diuresis, reduces the volume of the abdomen, makes laparocentesis unnecessary, improves the patients' general condition and allows some of them to be prepared for interventions on the organs of the portal system which are more radical in character.
