| Project/Area Number |
03807065
|
|---|
| Research Category |
Grant-in-Aid for General Scientific Research (C)
|
| Allocation Type | Single-year Grants |
|---|
| Research Field |
Radiation science
|
|---|
| Research Institution | KOBE UNIVERSITY |
|---|
Principal Investigator |
HIROTA Shozo Kobe University School of Medicine, Department of Radiology, Lecturer, 医学部・附属病院, 講師 (20181216)
|
|---|
| Co-Investigator(Kenkyū-buntansha) |
SAKO Masao Kobe University School of Medicine, Department of Radiology, Associate Professor, 医学部・附属病院, 助教授 (60030970)
KONO Michio Kobe University School of Medicine, Department of Radiology, Professor, 医学部, 教授 (60030938)
藤井 正彦 神戸大学, 医学部, 助手 (00228959)
藤田 善弘 神戸大学, 医学部附属病院, 助手 (00238594)
長江 利幸 神戸大学, 医学部附属病院, 助手 (20227987)
|
|---|
| Project Period (FY) |
1991 – 1993
|
| Project Status |
Completed (Fiscal Year 1993)
|
| Budget Amount *help |
¥1,800,000 (Direct Cost: ¥1,800,000)
Fiscal Year 1993: ¥400,000 (Direct Cost: ¥400,000)
Fiscal Year 1992: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 1991: ¥600,000 (Direct Cost: ¥600,000)
|
|---|
| Keywords | portosystemic shunt / TIPS / esophageal varix / liver cirrhosis / percutaneous transhepatic method / Ultrasonographic guidance / metallic stent / 経皮的シャント造設 |
|---|
| Research Abstract |
We studied of TIPS(Transjugular Intrahepatic Portosystemic Stent Shunt) abou percutaneous transhepatic method.
A)Experimental Study a)Puncture method : Experiment : To establish a safer puncture method for TIPS, we developed a new percutaneous puncture technique to penetrante portal and hepatic vein transhepatically uner ultrasonography(US technique). Using canines we compared this technique with conventional transjugular technique puncturing portal vein through hepatic vein using Ross needle(Ross Needle technique). Success rate is 100% in US technique and 50% in Ross needle technique. Severe complication including intraperitoneal bleeding occurred in Ross needle technique, but no complication is US technique. Conclusively, US technique is a safer and more reliable method than that using Ross needle in the puncture method for TIPSS.b)Tract closure ; A tract formed percutaneoluly tanshepatically, which connects portosystemic shunt, was successfully colsed with stainless steel coils of va
… More
rous sizes. c)Optimal metallic stent : Wallstent (Shneider C.C) was the best suitable stent for TIPS because of its softness, bending ability, expansile force. d)Dilatation of Unmbilical Vein : Rabbit or canine umbilical vein was so small that we could not dilate its vein experimentally.
B)Clinical Study : We formed an intrahepatic portosystemic shunt usign this method for a 64-year-old male with marked esophageal varix and liver cirrhosis, hepatic tumor. On ultrasonography, right lobe of the liver was shrunken and intrahepatic portal vein was hardly visible. So, we tried shnt formation in the left lobe. A shunt from left portal vein to left hepatic vein was successfully made and no complication was found. However, the shunt was obstructed after 3 months. This was done partly because metallic stent was not fully covered into the portal vein. Now, we are studying a new utilization of this transhepatic method to TIPS.
C)Conclusion : Our study revealed the transhepatic shunt formation to be a new and safe choice for TIPS. Less
|
