PERCUTANEOUS RETROPERITONEAL SPLENORENAL SHUNT - AN EXPERIMENTAL-STUDY IN SWINE

PURPOSE: To evaluate the technical possibility of creating a percutane ous retroperitoneal splenorenal shunt (PRESS) in swine as a minimally invasive treatment of portal hypertension. MATERIALS AND METHODS: Five normal domestic swine underwent creation of a PRESS. A modified trans jugular intrahepatic portosystemic shunt puncture set was introduced f rom the right femoral vein into the left renal vein. The proximal sple nic vein was punctured transvenously through the retroperitoneal cavit y, Noncovered metallic stents were then placed, to connect both veins. The animals were sacrifice 1 hour after the procedure, after follow-u p splenic venography land necropsy were performed. RESULTS: Puncture o f the splenic vein and stent placement were successfully completed in all cases. In four of five cases, the splenic venogram revealed good f low from the splenic vein to the left renal vein through the shunt tra ck 1 hour after creation of the PRESS, and there was no evidence of le akage. No changes in vital signs were noticed. At necropsy, a small re troperitoneal hematoma-along the stent and minimal intraperitoneal ble eding were observed. The stents were found in the retroperitoneal cavi ty connecting both veins in all animals. CONCLUSION: Creation of a PRE SS is technically possible, and further experimental studies of its ef ficacy are warranted.