Background And Objectives: Percutaneous portal vein (PV) stent placement is used to manage PV occlusion or stenosis caused by malignancy. The use of endoscopic ultrasonography (EUS) has expanded to include vascular interventions. The aim of this study was to examine the technical feasibility and safety of EUS-guided transhepatic PV stent placement in a live porcine model.
Materials And Methods: EUS-guided transhepatic PV stent placement was performed in six male miniature pigs under general anesthesia using forward-viewing echoendoscope. Under EUS guidance, the left intrahepatic PV was punctured with a 19-gauge fine-needle aspiration (FNA) needle and a 0.025 inch guidewire inserted through the needle and into the main PV. The FNA needle was then withdrawn and a needle-knife inserted to dilate the tract. Under EUS and fluoroscopic guidance, a noncovered metal stent was inserted over the guidewire and released into the main PV.
Results: A PV stent was placed successfully in all six pigs with no technical problems or complications. The patency of the stent in the main PV was confirmed using color Doppler EUS and transhepatic portal venography. Necropsy of the first three animals revealed no evidence of bleeding and damage to intra-abdominal organs or vessels. No complications occurred in the remaining three animals during the 8 weeks observation period.
Conclusions: EUS-guided transhepatic PV stent placement can be both technically feasible and safe in a live animal model.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070289 | PMC |
http://dx.doi.org/10.4103/2303-9027.191611 | DOI Listing |
Sci Rep
January 2025
Department of Ophthalmology and Visual Science, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku City, 783-8505, Kochi, Japan.
To assess the efficacy of using a nylon suture as a stent in the PreserFlo MicroShunt (PMS) lumen to prevent postoperative hypotony, 59 eyes that underwent PMS implantation with follow-up for > 6 months were analyzed. Patients were divided into no intrastenting (NST) and intrastenting (ST) groups, with the ST group subdivided into 9 - 0 nylon suture fully placed (9 F), 9 - 0 nylon suture placement in only half of the lumen (9 H), 10 - 0 nylon suture fully placed (10 F), and 10 - 0 nylon suture placement in only half of the lumen (10 H). The distribution was as follows: 23 eyes in the NST group, 10 in the 9 F group, 9 in the 9 H group, 11 in the 10 F group, and 6 in the 10 H group.
View Article and Find Full Text PDFAJNR Am J Neuroradiol
January 2025
Ataxia Center, Cognitive Behavioral Neurology Unit, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Department of Neurology (J.D.S., Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Background And Purpose: Symptoms indistinguishable from behavioral-variant frontotemporal dementia (bvFTD) can develop in patients with spontaneous intracranial hypotension associated with severe brain sagging. An underlying spinal CSF leak can be identified in only a minority of these patients and the success rate of nondirected treatments, such as epidural blood patching and dural reduction surgery, is low. The disability associated with bvFTD sagging brain syndrome is high and, because of the importance of the venous system in the pathophysiology of CSF leaks in general, we have investigated the systemic venous circulation in those patients with recalcitrant symptoms.
View Article and Find Full Text PDFEndoscopy
December 2025
Gastroenterology, Kakogawa Central City Hospital, Kakogawa, Japan.
AJNR Am J Neuroradiol
January 2025
From the Department of Radiology (J.L., E.A.B., C.B., J.C., R.K., W.B., D.F.K), and Department of Neurologic Surgery (Y.C.S., R.K., W.B.), Mayo Clinic, Rochester, MN, United States; Department of Stroke Research (J.L.), Vall d'Hebron Research Institute, Barcelona, Spain; From the Global Institute of Future Technology (Y.L.), Shanghai Jiao Tong University, Shanghai, China; Department of Neurointerventional Radiology (J.C.), Bicetre University Hospital, Le Kremlin Bicetre, France.
Background And Purpose: Proximal protection devices, such as TransCarotid Artery Revascularization (TCAR, SilkRoad Medical, Sunnyvale), aim to yield better outcomes in carotid artery stenting (CAS) than distal protection devices by preventing plaque embolization to the brain. However, transfemoral catheters may not fully reverse flow from the external carotid artery (ECA) to the internal carotid artery (ICA). We assess a new balloon-sheath device, Femoral Flow Reversal Access for Carotid Artery Stenting (FFRACAS), for this purpose.
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