Percutaneous control of a portacaval H-graft

Description of a new device and its initial clinical application

Ross C. Smith*, Alastair R. Brown, Peter C. Spencer, Robert W. Gill, Kaye A. Griffiths, Rodney J. Lane, Thomas S. Reeve

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish
Pages (from-to)235-240
Number of pages6
JournalWorld Journal of Surgery
Volume14
Issue number2
DOIs
Publication statusPublished - Mar 1990
Externally publishedYes

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